Provider Demographics
NPI:1811617152
Name:RODRIGUEZ, SHELBY F (RDN)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:F
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:FIELDS
Other - Last Name:PANTTAJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1170 JACOBS DR APT 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-2094
Mailing Address - Country:US
Mailing Address - Phone:208-669-0681
Mailing Address - Fax:
Practice Address - Street 1:1170 JACOBS DR APT 2
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2094
Practice Address - Country:US
Practice Address - Phone:208-669-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR86290994133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered