Healthcare Provider Details
I. General information
NPI: 1396043709
Provider Name (Legal Business Name): INEKE M. OJANEN R.D,, C.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2011
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2036 NE WILLIAMSON CT
BEND OR
97701-3771
US
IV. Provider business mailing address
PO BOX 6095
BEND OR
97708-6095
US
V. Phone/Fax
- Phone: 541-382-4321
- Fax: 541-706-2918
- Phone: 541-706-5922
- Fax: 541-706-5922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | DI60159787 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | D10219335 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: