Provider Demographics
NPI:1790979029
Name:MARNEY, CHRISTA M (RD, LD)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:M
Last Name:MARNEY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:M
Other - Last Name:OHLRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 SW COLUMBIA ST
Mailing Address - Street 2:SUITE 6210
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1099
Mailing Address - Country:US
Mailing Address - Phone:541-383-3005
Mailing Address - Fax:
Practice Address - Street 1:2965 NE CONNERS AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7753
Practice Address - Country:US
Practice Address - Phone:541-323-4269
Practice Address - Fax:541-383-1883
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000824133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500639618Medicaid
ORR172983Medicare PIN