Michelle L Skidmore, RDN, CDCES

Individual provider Active NPI Registered Dietitian · La Conner, WA

NPI 1114080934 · NPPES record last updated Jan 26, 2026

Key facts

NPI
1114080934
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
DI00001414 (WA)
Practice address
17400 Reservation Rd
La Conner, WA 98257-8801
Phone
(360) 466-3167
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DI00001414WAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00001414 WA Yes

Addresses

Primary practice location

17400 Reservation Rd
La Conner, WA 98257-8801

Mailing address

PO Box 683
La Conner, WA 98257-0683
Phone (360) 466-3167

Other providers in La Conner, WA

All providers in La Conner, WA · Registered Dietitian in Washington

Sources for this page

Verify at the official NPI Registry.