Provider Demographics
NPI:1316027626
Name:COX, DANA ELLEN (RD)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ELLEN
Last Name:COX
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38901 S RUBY LOOP
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:OR
Mailing Address - Zip Code:97374-9708
Mailing Address - Country:US
Mailing Address - Phone:503-394-3990
Mailing Address - Fax:541-812-4004
Practice Address - Street 1:913 NW GARDEN VALLEY BLVD
Practice Address - Street 2:NUTRITION & FOOD SERVICES
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-440-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
112054OtherPIN#
873928OtherREGISTRATION NUMBER - RD
OR000544OtherLICENSE NUMBER - LD