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General NPI Number Information
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NPI Number | 1619534039
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Entity Type | Individual
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Provider Name | KATIE MERSINGER RDN
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Gender | Female
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 1750 MCGILCHRIST ST SE
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City | SALEM
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State | OR
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Zip | 97302-1691
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Country | US
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Telephone | 360-905-1745
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Fax |
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Provider Business Mailing Address
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Address Line | 29317 SW TAMI LOOP APT 169
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City | WILSONVILLE
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State | OR
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Zip | 97070-6526
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Country | US
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Telephone | 618-402-7412
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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 |
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License Number State |
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