Individual
HEIDI R GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4530
(541) 812-4004
Mailing address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4530
(541) 812-4004
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-000875
OR
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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