Provider Demographics
NPI:1033079215
Name:GILBERT, HEATHER CHRISTINE (RD, LD, MBA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RD, LD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 MINEAR RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-9536
Mailing Address - Country:US
Mailing Address - Phone:541-324-1700
Mailing Address - Fax:
Practice Address - Street 1:1614 MINEAR RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-9536
Practice Address - Country:US
Practice Address - Phone:541-324-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10259063133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty