Healthcare Provider Details

I. General information

NPI: 1184397176
Provider Name (Legal Business Name): JOEL DANIEL DULING RD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST STE 550
EUGENE OR
97401-8153
US

IV. Provider business mailing address

1200 HILYARD ST STE 550
EUGENE OR
97401-8153
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-6543
  • Fax: 458-205-6492
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number10253629
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: