Provider Demographics
NPI:1518754100
Name:MARTIN, ANDRIA JOY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:ANDRIA
Middle Name:JOY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:ANDRIA
Other - Middle Name:JOY
Other - Last Name:HOMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:973 LORELLA AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7868
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:973 LORELLA AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7868
Practice Address - Country:US
Practice Address - Phone:480-347-7078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86288886133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered