Most Relevant Information
Provider Data
| NPI Number: | 1003067133 |
| Provider Name: | LILE D ELLEFSEN RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | DI00000922 |
Most Important Dates
| Enumeration Date: | 10/07/2008 |
| Last Updated: | 10/07/2008 |
Provider Practice Location
13008 NE 125TH WAY
KIRKLAND
WA
980347726
Practice Location Phone/Fax
| Phone: | 4258148443 |
| Fax: |
Provider Mailing Location
12906 NE 128TH PL
KIRKLAND
WA
980347901
Provider Mailing Phone/Fax
| Phone: | 4258237764 |
| Fax: |