Healthcare Provider Details

I. General information

NPI: 1841540432
Provider Name (Legal Business Name): ERICA VAN MIEGHEM NUTRITION CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W HOLLY ST SUITE 2D
BELLINGHAM WA
98225-2940
US

IV. Provider business mailing address

PO BOX 5791
BELLINGHAM WA
98227-5791
US

V. Phone/Fax

Practice location:
  • Phone: 206-902-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU 60183469
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number977132
License Number StateWA

VIII. Authorized Official

Name: MRS. ERICA VAN MIEGHEM
Title or Position: REGISTERED DIETITIAN/NUTRITIONIST
Credential: MS, RD, CD, CN
Phone: 206-902-8000