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1104125608
AUDREY EASTTUM
PORTLAND, OR
NPI
1104125608
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: OR 1016)
Enumeration Date
2011-03-23
Last Update Date
2022-03-08
Business Address
AUDREY EASTTUM RD, CSP, LD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-418-5257
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Mailing Address
AUDREY EASTTUM RD, CSP, LD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number:
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