| NPI | 1689181976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA COUGHLIN Owner 541-279-3696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR LD-D-10177506) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: CA 01013025) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |