Provider Demographics
NPI:1871253724
Name:DURKEE, ALLISON RAE (RD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RAE
Last Name:DURKEE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RAE
Other - Last Name:FORNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:4401 SE ROCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5009
Mailing Address - Country:US
Mailing Address - Phone:503-780-4686
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-571-5154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1081404133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered