Thomas Bosch, PHD, RDN, LDN

Individual provider Active NPI Registered Dietitian · Eugene, OR

NPI 1972056562 · NPPES record last updated Jul 29, 2016

Key facts

NPI
1972056562
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
10177915 (OR)
Practice address
2455 Fieldcress Rd
Eugene, OR 97403-3255
Phone
(541) 505-7758
Fax
(541) 505-7758
NPI assigned
Jul 29, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10177915ORMDNutritionist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 10177915 OR
Nutrition Education Nutritionist 133NN1002X 10177915 OR
Registered Dietitian 133V00000X 10177915 OR Yes

Addresses

Primary practice location

2455 Fieldcress Rd
Eugene, OR 97403-3255

Mailing address

2455 Fieldcress Rd
Eugene, OR 97403-3255
Phone (541) 505-7758

Other providers in Eugene, OR

All providers in Eugene, OR · Registered Dietitian in Oregon

Sources for this page

Verify at the official NPI Registry.