Provider Demographics
NPI:1306635594
Name:JARVIS, HANNAH (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:JARVIS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 ELKHORN DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7170
Mailing Address - Country:US
Mailing Address - Phone:541-513-3134
Mailing Address - Fax:
Practice Address - Street 1:296 E 5TH AVE STE 324
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2771
Practice Address - Country:US
Practice Address - Phone:541-600-4464
Practice Address - Fax:440-556-5642
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLD-D-10221502133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered