Organization Name: | JORDAN BOUCHER |
NPI Number: | 1942697198 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JORDAN LYNN BOUCHER (REGISTERED DIETITIAN) |
Mailing Address: | 3333 Se Horstman Rd Port Orchard |
State: | WA US |
Postal Code: | 983664054 |
Phone Number: | 7136899673 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2015 |
NPI Last Update Date: | 04/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DI 60543717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |