Individual
VICKI LYNN DUESTERHOEFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 945-9826
(503) 945-9864
Mailing address
17025 OAKDALE RD, DALLAS, OR 97338-9646
(503) 623-3112
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000799
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000799
OREGON HEALTH LICENSING BOARD OF LICENSED DIETITIANS
OR
01
—
818835
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
08/16/2019
Last updated
08/16/2019
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