Healthcare Provider Details

I. General information

NPI: 1295775666
Provider Name (Legal Business Name): ELIZABETH A FUJII M.P.H., R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH A SIEBEN M.P.H., R.D., L.D.

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CAPITOL ST NE
SALEM OR
97303-3244
US

IV. Provider business mailing address

PO BOX 8100
SALEM OR
97303-0900
US

V. Phone/Fax

Practice location:
  • Phone: 503-399-2424
  • Fax: 503-375-7429
Mailing address:
  • Phone: 503-399-2424
  • Fax: 503-375-7429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: