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General NPI Number Information
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NPI Number | 1710834502
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Entity Type | Organization
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Legal Business Name | LOVE YOURSELF NUTRITION
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 20879 DANIEL DUKE WAY
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City | BEND
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State | OR
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Zip | 97701-7025
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Country | US
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Telephone | 541-908-5126
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Fax | 458-292-1756
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Provider Business Mailing Address
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Address Line | 20879 DANIEL DUKE WAY
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City | BEND
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State | OR
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Zip | 97701-7025
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Country | US
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Telephone | 541-908-5126
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Fax | 458-292-1756
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Authorized Official
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Title or Position | OWNER/REGISTERED DIETITIAN
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Name | KELLY MOFFATT
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Credential | RDN
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Telephone | 541-908-5126
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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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