Individual
MISS WENDY N ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, RDN
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
Mailing address
811 MORRISON AVE UNIT A, MEDFORD, OR 97504-8455
(360) 434-4700
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86145556
OR
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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