Provider Demographics
NPI:1811171374
Name:STUECK, DANIELLE NADINE (RD)
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:NADINE
Last Name:STUECK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 NE CREEKSEDGE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-3193
Mailing Address - Country:US
Mailing Address - Phone:503-939-6023
Mailing Address - Fax:
Practice Address - Street 1:875 NE CREEKSEDGE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3193
Practice Address - Country:US
Practice Address - Phone:503-939-6023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered