Individual
JESSICA ROSE DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2639 DONEGAL ST, EUGENE, OR 97404-1963
(217) 370-5863
(866) 244-8819
Mailing address
2639 DONEGAL ST, EUGENE, OR 97404-1963
(217) 370-5863
(866) 244-8819
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DI61023969
WA
133V00000X
Registered Dietitian
DT89050
TX
133V00000X
Registered Dietitian
Primary
LD-D10209815
OR
Other
Enumeration date
08/18/2021
Last updated
11/06/2023
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