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NPI Code Detail

MEDICARE: VICTORIA R PADRON RD, LD, CD

MEDICARE:   VICTORIA R PADRON  RD, LD, CD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian453732OR

General Provider Information

NPI Number : 1972131001
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA R PADRON RD, LD, CD
Provider Business Mailing Address
First Line : 3723 FAIRVIEW INDUSTRIAL DR SE STE 170
Second Line :
City : SALEM
State : OR
Zip : 97302-1174
Country : US
Telephone Number : 503-371-1970
Fax Number :
Provider Business Practice Location Address
First Line : 3723 FAIRVIEW INDUSTRIAL DR SE STE 170
Second Line :
City : SALEM
State : OR
Zip : 97302-1174
Country : US
Telephone Number : 503-371-1970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 07/27/2022

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Directions to “ VICTORIA R PADRON RD, LD, CD” Practice Location

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