PORTLAND PEDIATRIC NUTRITION

PORTLAND, OR
NPI1972012409
Entity TypeOrganization
Authorized ContactKATHARINE BURTON JEFFCOAT
Dietitian/Owner
503-997-8897
Organization Subpart ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: OR  LD-D-000479)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: WA  DI60717826)
133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: OR  LD-D-000479)
Enumeration Date2017-09-27
Last Update Date2018-03-17
Business Address
PORTLAND PEDIATRIC NUTRITION
1730 SW SKYLINE BLVD STE 226
PORTLAND, OR 97221-2549
Phone number: 971-319-1288
Mailing Address
PORTLAND PEDIATRIC NUTRITION
3230 SW GALE AVE
PORTLAND, OR 97239-1450
Phone number: 503-997-8897