Provider Demographics
NPI:1871671149
Name:DAHLE, JARED HILL (RD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:HILL
Last Name:DAHLE
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KADENA HEALTH & WELLNESS CENTER
Mailing Address - Street 2:18 AMDS/SGPZ
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5267
Mailing Address - Country:US
Mailing Address - Phone:315-634-0180
Mailing Address - Fax:
Practice Address - Street 1:KADENA HEALTH & WELLNESS CENTER
Practice Address - Street 2:18 AMDS/SGPZ
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5267
Practice Address - Country:US
Practice Address - Phone:315-634-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
912883133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered