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1336484864
MIRIAM SARA BALLEJOS
TACOMA, WA
NPI
1336484864
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Former Name
MIRIAM SARA EDLEFSEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: WA DI60224467)
Enumeration Date
2012-12-10
Last Update Date
2020-05-19
Business Address
MIRIAM SARA BALLEJOS PhD, RD
9040A JACKSON AVE
TACOMA, WA 98431
Phone number: 253-968-0547
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Mailing Address
MIRIAM SARA BALLEJOS PhD, RD
9040A JACKSON AVE
TACOMA, WA 98431-0001
Phone number: 253-968-0547
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