MEDICARE: MS. DIXIE RHODES HAVLAK R.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
1	133V00000X	Registered Dietitian	DI00000195	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710057666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIXIE RHODES HAVLAK R.D.

Provider Business Mailing Address
First Line	:	1613 CAMDEN CIR SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98512-5552
Country	:	US
Telephone Number	:	360-357-1410
Fax Number	:	360-357-1410

Provider Business Practice Location Address
First Line	:	1822 BLACK LAKE BLVD SW
Second Line	:	SUITE 102-C
City	:	OLYMPIA
State	:	WA
Zip	:	98512-5628
Country	:	US
Telephone Number	:	360-357-1410
Fax Number	:	360-357-1410

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1811850431 — HUNTER MILLER
Practice Location Address:

1822 BLACK LAKE BLVD SW STE 103
OLYMPIA, WA
98512-5628

Practice Phone: 360-943-0988
Practice Fax:

1487732145 — DR. EDWARD I. DAGHER MD
Practice Location Address:

1822 BLACK LAKE BLVD SW , SUITE 102
OLYMPIA, WA
98512-5628

Practice Phone: 360-877-8862
Practice Fax: 360-878-8619

1154456424 — JON KEVIN TAYLOR DC
Practice Location Address:

1822 BLACK LAKE BLVD SW STE 103 , NORTHWEST CHIROPRACTIC CENTER
OLYMPIA, WA
98512-5628

Practice Phone: 360-943-0988
Practice Fax: 360-943-8021

1285853788 — MRS. HEIDI ELLIS RDH
Practice Location Address:

1822 BLACK LAKE BLVD SW STE 101
OLYMPIA, WA
98512-5628

Practice Phone: 360-709-9909
Practice Fax: 360-709-9915

1720242969 — BRENDA MARIE CORKUM MA LMHC
Practice Location Address:

1822 BLACK LAKE BLVD SW , SUITE 102-D
OLYMPIA, WA
98512-5628

Practice Phone: 360-866-2919
Practice Fax: 360-943-5382

1568704195 — LISA MCCULLOUGH D.C.
Practice Location Address:

1822 BLACK LAKE BLVD SW STE 103
OLYMPIA, WA
98512-5628

Practice Phone: 360-943-0988
Practice Fax: 615-264-8879

Directions to “ MS. DIXIE RHODES HAVLAK R.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.