Healthcare Provider Details

I. General information

NPI: 1639562952
Provider Name (Legal Business Name): TOK-HUI YEAP RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5453 KING ARTHUR CT
EUGENE OR
97402-7589
US

IV. Provider business mailing address

5453 KING ARTHUR CT
EUGENE OR
97402-7589
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-7883
  • Fax: 541-833-7883
Mailing address:
  • Phone: 541-357-7883
  • Fax: 541-833-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number10154573
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: