Doctor Name: | MS. JESSICA WILSON |
NPI Number: | 1992822316 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 962666 |
Business Practice Address: | 2650 Suzanne Way Ste 200 Eugene, OR - 974087619 |
Business Phone Number: | 5412283020 |
Business Fax Number: | |
Mailing Address: | 650 W 12th Ave Apt 227, EUGENE |
State: | OR |
Postal Code: | 974024087 |
Phone Number: | 5412283020 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 04/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 962666 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
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 |