Micca David Henry, RDN

NPI #1649047952 in White City, Oregon

Provider Information

NPI Number: 1649047952
Entity Type: Individual
Name: Micca David Henry, RDN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: RDN
Enumeration Date: Dec 6, 2023
Last Updated: Dec 6, 2023

Practice Location

Address: 8495 CRATER LAKE HWY
Address 2: MAIL STOP: 120
City: White City
State: Oregon
ZIP Code: 97503
Phone: (541) 826-2111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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