Provider Demographics
NPI:1649816745
Name:JENSEN, ALLISON (RD, LD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:MOBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2314 HEMPSTEAD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0259
Mailing Address - Country:US
Mailing Address - Phone:775-722-6881
Mailing Address - Fax:
Practice Address - Street 1:1200 MIRA MAR AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8546
Practice Address - Country:US
Practice Address - Phone:541-857-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered