Provider Demographics
NPI:1326100116
Name:BOYCE, VICKY LYNN (MS RD)
Entity Type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:LYNN
Last Name:BOYCE
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 CHEMAWA RD NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1119
Mailing Address - Country:US
Mailing Address - Phone:503-304-7600
Mailing Address - Fax:503-304-7678
Practice Address - Street 1:3750 CHEMAWA RD NE
Practice Address - Street 2:CHEMAWA INDIAN HEALTH CENTER WESTERN OREGON SERVICE UNI
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1119
Practice Address - Country:US
Practice Address - Phone:503-304-7600
Practice Address - Fax:503-304-7678
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL506429133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered