Provider Demographics
NPI:1255958112
Name:MARKHAM, KATHARINE ZIMMER (RDN)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ZIMMER
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 W ALDER ST STE 28
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4026
Mailing Address - Country:US
Mailing Address - Phone:406-239-3336
Mailing Address - Fax:833-803-1538
Practice Address - Street 1:725 W ALDER ST STE 28
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4026
Practice Address - Country:US
Practice Address - Phone:406-239-0078
Practice Address - Fax:833-803-1538
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT88245133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered