| NPI | 1275604399 |
|---|---|
| Doing Business As | MEDICAL NUTRITION THERAPY NORTHWEST |
| Doing Business As | LIFESTYLE MEDICINE GROUP |
| Entity Type | Organization |
| Authorized Contact | JOHN ELLIS GOBBLE President 503-652-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2018-10-21 |