Individual
GRACE ODEGARD PASCALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2339 11TH ST, ENCINITAS, CA 92024-6604
(425) 736-9908
Mailing address
PO BOX 7042, RANCHO SANTA FE, CA 92067-7042
(425) 736-9908
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86108115
CDR #
CA
Enumeration date
01/05/2022
Last updated
01/05/2022
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