Healthcare Provider Details

I. General information

NPI: 1902846702
Provider Name (Legal Business Name): NORIKO N DELACRUZ R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NORIKO N NARITA R.D.

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HILYARD ST STE 550
EUGENE OR
97401-8153
US

IV. Provider business mailing address

1115 SE 164TH AVE DEPT 358
VANCOUVER WA
98683-8004
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-6543
  • Fax: 458-205-6492
Mailing address:
  • Phone: 360-729-1253
  • Fax: 360-729-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number941714
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-D-10196283
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: