MEDICARE: MEAGAN AYOUB RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD-D-10215557	OR

General Provider Information

NPI Number	:	1841131497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN AYOUB RD

Provider Business Mailing Address
First Line	:	1530 23RD ST SE APT 324
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-1497
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 23RD ST SE APT 324
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-1497
Country	:	US
Telephone Number	:	505-803-4994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “ MEAGAN AYOUB RD” Practice Location

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