Healthcare Provider Details

I. General information

NPI: 1740084326
Provider Name (Legal Business Name): ASHLEE ESKELSEN MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 GRAYLING DR
FAIRLAWN OH
44333-2844
US

IV. Provider business mailing address

194 GRAYLING DR
FAIRLAWN OH
44333-2844
US

V. Phone/Fax

Practice location:
  • Phone: 509-595-0013
  • Fax:
Mailing address:
  • Phone: 509-595-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.09671
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: