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General NPI Number Information
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NPI Number | 1477346831
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Entity Type | Individual
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Provider Name | KARI MARIE HENDRICKSON RDN, LD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 3600 NW SAMARITAN DR
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City | CORVALLIS
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State | OR
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Zip | 97330-5472
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Country | US
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Telephone | 541-768-4663
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Fax |
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Provider Business Mailing Address
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Address Line | 454 CHERRYWOOD CT SE
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City | SALEM
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State | OR
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Zip | 97306-3515
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Country | US
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Telephone | 208-901-0517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD-D-10249600
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License Number State | OR
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