NPI 1023366770

Shannon Thorum, MSRDLD

Practitioner Pediatric Nutrition Registered Dietitian Portland, OR

Practice location

Address: 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011
Phone: (503) 418-5257
Fax: (503) 494-3769

Registered specialties

Pediatric Nutrition Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133VN1004X Licence LDD10144588 (OR)

Other Dietitian, Registered providers in Oregon →

Registry record

NPI: 1023366770
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Aug 2012
Record last updated: 28 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.