Provider Demographics
NPI:1407444342
Name:MCDONNELL, MORGAN MYKEL (RD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:MYKEL
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3003
Mailing Address - Country:US
Mailing Address - Phone:406-696-4231
Mailing Address - Fax:
Practice Address - Street 1:4 NICKERSON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1651
Practice Address - Country:US
Practice Address - Phone:866-221-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered