Provider Demographics
NPI:1629350210
Name:CICHY, MEGHAN (RDN, CD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:CICHY
Suffix:
Gender:F
Credentials:RDN, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6642 S 193RD PL STE N106
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-3109
Mailing Address - Country:US
Mailing Address - Phone:206-569-8002
Mailing Address - Fax:
Practice Address - Street 1:6642 S 193RD PL STE N106
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-3109
Practice Address - Country:US
Practice Address - Phone:206-569-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1054337133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered