Provider Demographics
NPI:1689216459
Name:TADINA, SELDOVIA JUGUILON (RDN)
Entity Type:Individual
Prefix:
First Name:SELDOVIA
Middle Name:JUGUILON
Last Name:TADINA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2723
Mailing Address - Country:US
Mailing Address - Phone:907-830-3379
Mailing Address - Fax:
Practice Address - Street 1:2801 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2932
Practice Address - Country:US
Practice Address - Phone:907-264-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered