Jacie L Van Blaricom, DI
NPI #1780080515 in Grand Coulee, Washington
Provider Information
- NPI Number
- 1780080515
- Entity Type
- Individual
- Name
- Jacie L Van Blaricom, DI
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dietitian, Registered
- Credential
- DI
- Enumeration Date
- Nov 5, 2014
- Last Updated
- Mar 13, 2018
Practice Location
- Address
- 411 FORTUYN RD
- City
- Grand Coulee
- State
- Washington
- ZIP Code
- 99133-8718
- Phone
- (509) 633-1753
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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