Healthcare Provider Details

I. General information

NPI: 1295764371
Provider Name (Legal Business Name): MELISSA K NAFF RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SE COURT AVE
PENDLETON OR
97801-3217
US

IV. Provider business mailing address

1601 SE COURT AVE
PENDLETON OR
97801-3217
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-5121
  • Fax: 541-966-0504
Mailing address:
  • Phone: 541-276-5121
  • Fax: 541-966-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDD001026
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: