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NPI Code Detail

MEDICARE: KAILEY CUNNINGHAM M.S., R.D.N., C.D.

MEDICARE:   KAILEY  CUNNINGHAM  M.S., R.D.N., C.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDI 60593826WA

General Provider Information

NPI Number : 1528439627
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILEY CUNNINGHAM M.S., R.D.N., C.D.
Provider Business Mailing Address
First Line : 673 WOODLAND SQUARE LOOP SE
Second Line : SUITE 330
City : LACEY
State : WA
Zip : 98503-1066
Country : US
Telephone Number : 888-364-5977
Fax Number : 360-628-5240
Provider Business Practice Location Address
First Line : 673 WOODLAND SQUARE LOOP SE
Second Line : SUITE 330
City : LACEY
State : WA
Zip : 98503-1066
Country : US
Telephone Number : 888-364-5977
Fax Number : 360-628-5240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2015
Last Update Date : 10/14/2015

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Directions to “ KAILEY CUNNINGHAM M.S., R.D.N., C.D.” Practice Location

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