Healthcare Provider Details

I. General information

NPI: 1669705752
Provider Name (Legal Business Name): ANN M LACHNEY R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BATTERSBY AVE
ENUMCLAW WA
98022-3634
US

IV. Provider business mailing address

1450 BATTERSBY AVE P.O. BOX 218
ENUMCLAW WA
98022-3634
US

V. Phone/Fax

Practice location:
  • Phone: 360-832-2505
  • Fax:
Mailing address:
  • Phone: 360-832-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI 00000643
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: