Individual
HOLLY NICOLE WEARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 451-7122
(541) 451-7080
Mailing address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 451-7122
(541) 451-7080
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10164585
OR
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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