IndividualActive
Alicia Susilla, BS
NPI 1154315968 · Registered Dietitian · Longview, WA
Provider details
- NPI number
- 1154315968
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- BS
- Sex
- Female
- Sole proprietor
- No
- License
- DI00001601 (WA)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
600 Broadway St
Longview, WA 98632-3256
Phone: (360) 414-2200
Fax: (360) 414-2210
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 249
Longview, WA 98632-7154
Registry dates
- Enumerated
- 2005-09-07
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.