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NPI Code Detail

MEDICARE: CAILIE A BUCKINGHAM R.D.

MEDICARE: CAILIE A BUCKINGHAM 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
1133V00000XRegistered Dietitian2624MN
2133V00000XRegistered DietitianDI60455187WA

General Provider Information

NPI Number : 1962554972
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAILIE A BUCKINGHAM R.D.
Provider Business Mailing Address
First Line : 1345 KING ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229-6223
Country : US
Telephone Number : 360-676-1696
Fax Number :
Provider Business Practice Location Address
First Line : 1345 KING ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229-6223
Country : US
Telephone Number : 360-676-1696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 09/23/2020

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Directions to “ CAILIE A BUCKINGHAM R.D.” Practice Location

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