Nicole Kimberly Tjakralaksana
NPI #1043083777 in Fircrest, Washington
Provider Information
- NPI Number
- 1043083777
- Entity Type
- Individual
- Name
- Nicole Kimberly Tjakralaksana
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Nov 3, 2023
- Last Updated
- Nov 3, 2023
Practice Location
- Address
- 105 MAPLE ST
- City
- Fircrest
- State
- Washington
- ZIP Code
- 98466-6617
- Phone
- (909) 718-9203
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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