Healthcare Provider Details

I. General information

NPI: 1306635594
Provider Name (Legal Business Name): HANNAH JARVIS MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 E 5TH AVE STE 324
EUGENE OR
97401-2771
US

IV. Provider business mailing address

1830 ELKHORN DR
EUGENE OR
97408-7170
US

V. Phone/Fax

Practice location:
  • Phone: 541-600-4464
  • Fax: 440-556-5642
Mailing address:
  • Phone: 541-513-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-D-10221502
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: