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1760980874
SUZANNE BLACK
PORTLAND, OR
NPI
1760980874
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OR LD-D-000313)
Enumeration Date
2018-01-24
Last Update Date
2019-04-03
Business Address
SUZANNE BLACK RDN
5211 NE GLISAN ST BLDG C
PORTLAND, OR 97213-3052
Phone number: 503-215-6628
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Mailing Address
SUZANNE BLACK RDN
PO BOX 3158
PORTLAND, OR 97208-3158
Phone number:
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