Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacie L Van Blaricom, DI

Individual provider Registered Dietitian · NPI 1780080515

Jacie L Van Blaricom, DI is a Registered Dietitian in Grand Coulee, Washington. Licensed in Washington. Registered with an NPI since 2014.

Licensed in
WA
In the registry since
2014

Practice location Address checks out

411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone: (509) 633-1753
Fax: (509) 633-1933
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence DI60513122 (WA)

Record details

NPI number1780080515
Entity typeIndividual (Type 1)
GenderFemale
Credentials DI
Sole proprietorNo
NPI enumeratedNovember 5, 2014
Last updated in NPPESMarch 13, 2018

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