Henry, Micca David
Henry, Micca David is an individual health care provider with primary practice located at 8495 Crater Lake Hwy Mail Stop: 120, White City OR 97503. He recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as his primary health care specialty. Henry, Micca David can be contacted via phone (541) 826-2111.Contact Information
Primary practice address
8495 Crater Lake Hwy Mail Stop: 120
White City OR 97503
Phone: (541) 826-2111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X |
Profile Details
| NPI number | 1649047952 |
|---|---|
| LBN Legal business name | Henry, Micca David |
| Credentials | RDN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2023 |
| Last updated | Dec 6th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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