Healthcare Provider Details

I. General information

NPI: 1144552936
Provider Name (Legal Business Name): TRISHA D ALDERSON MPH, RD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2036 NE WILLIAMSON CT
BEND OR
97701-3771
US

IV. Provider business mailing address

1501 NE MEDICAL CENTER DR
BEND OR
97701-6051
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-6348
  • Fax:
Mailing address:
  • Phone: 541-382-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number928232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: