ALICIA D SUSILLA

LONGVIEW, WA
NPI1154315968
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: WA  DI00001601)
Enumeration Date2005-09-07
Last Update Date2007-07-09
Business Address
-- ALICIA D SUSILLA BS
600 BROADWAY ST
LONGVIEW, WA 98632-3256
Phone number: 360-414-2200
Mailing Address
-- ALICIA D SUSILLA BS
PO BOX 249
LONGVIEW, WA 98632-7154
Phone number:
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