NPI 1831506815

Robert Wilson

Practitioner Registered Dietetic Technician Portland, OR

Practice location

Address: 7201 N Interstate Ave, Portland, OR 97217-5523
Phone: (503) 240-4088

Registered specialties

Registered Dietetic Technician Primary

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 525079 (IL)

Other Dietetic Technician, Registered providers in Oregon →

Registry record

NPI: 1831506815
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jul 2014
Record last updated: 22 Jul 2014

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.