NPI 1447517933 · live from the CMS NPI Registry
Kevin Blume, R.D.
Dietitian, Registered in Pullman, WA. National Provider Identifier 1447517933, active.
NPI record
| NPI | 1447517933 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1225 N Grand Ave # B, Pullman, WA 99163 |
| Practice phone | 208-890-5241 |
| Mailing address | 254 Baker St Apt 4, Moscow, ID 83843 |
| Enumerated | April 20, 2012 |
| Last updated | April 20, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | DI 60270930 (WA) |
| Dietitian, Registered | 133V00000X | D-683 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.