Individual
JESSICA RAE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1000 N LINCOLN AVE, SUTIE 2900, OKLAHOMA CITY, OK 73104
(405) 271-3652
(405) 271-7522
Mailing address
5701 N PORTLAND AVE, STE 125, OKLAHOMA CITY, OK 73112-1670
(405) 604-4498
(405) 604-4195
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
1644
OK
Other
Enumeration date
09/15/2011
Last updated
04/14/2016
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