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Individual

TRACIE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
384 SE COMBS FLAT RD, PRINEVILLE, OR 97754-2562
(541) 460-4088
Mailing address
384 SE COMBS FLAT RD, PRINEVILLE, OR 97754-2562
(541) 460-4088

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
527628
OR
133V00000X
Registered Dietitian
Primary
LD-D-10200368
OR

Other

Enumeration date
03/01/2021
Last updated
03/01/2021
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