Healthcare Provider Details

I. General information

NPI: 1164348082
Provider Name (Legal Business Name): ALEXANDRIA JUDITH RICHMOND RD, LD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEXI RICHMOND

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 TYLER AVE
CENTRAL POINT OR
97502-2781
US

IV. Provider business mailing address

263 TYLER AVE
CENTRAL POINT OR
97502-2781
US

V. Phone/Fax

Practice location:
  • Phone: 208-870-9727
  • Fax:
Mailing address:
  • Phone: 208-870-9727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number9181213
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-D-10243880
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: