Individual
MS. JESSICA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2650 SUZANNE WAY STE 200, EUGENE, OR 97408-7619
(541) 228-3020
Mailing address
650 W 12TH AVE APT 227, EUGENE, OR 97402-4087
(541) 228-3020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
962666
CA
133V00000X
Registered Dietitian
962666
OR
Other
Enumeration date
03/22/2007
Last updated
04/08/2014
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