Provider Demographics
NPI:1285892257
Name:MUNCHEL, LESLIE ANN (RDN-AP, CD)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:MUNCHEL
Suffix:
Gender:F
Credentials:RDN-AP, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14701 179TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1108
Mailing Address - Country:US
Mailing Address - Phone:360-794-1447
Mailing Address - Fax:360-794-1420
Practice Address - Street 1:14701 179TH AVE SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1108
Practice Address - Country:US
Practice Address - Phone:360-794-1447
Practice Address - Fax:360-794-1420
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00002087133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered