Provider Demographics
NPI:1497326961
Name:WAKEFIELD, DELANEY MICHELLE (MS, RD)
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:MICHELLE
Last Name:WAKEFIELD
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14912 N PEONE PINES DR
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-9471
Mailing Address - Country:US
Mailing Address - Phone:509-499-2010
Mailing Address - Fax:
Practice Address - Street 1:14912 N PEONE PINES DR
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021-9471
Practice Address - Country:US
Practice Address - Phone:509-499-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered