Provider Demographics
NPI:1598462087
Name:NEWELL, JESSICA (BS, CSCS, NTP, RWP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:BS, CSCS, NTP, RWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 BEDFORD WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5523
Mailing Address - Country:US
Mailing Address - Phone:541-954-3358
Mailing Address - Fax:
Practice Address - Street 1:2260 BEDFORD WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5523
Practice Address - Country:US
Practice Address - Phone:541-954-3358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty