IndividualActive
Angie Frederic, RD, LD, CDE
NPI 1629155080 · Registered Dietitian · Lebanon, OR
Provider details
- NPI number
- 1629155080
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD, LD, CDE
- Sex
- Female
- Sole proprietor
- No
- License
- 593 (OR)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone: (541) 451-7197
Fax: (541) 451-6304
Approximate (ZIP-level) locationGet directions
Mailing address
213 Violet St
Lebanon, OR 97355-1570
Registry dates
- Enumerated
- 2006-11-01
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.