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Organization
HUMLIE MEDICAL NUTRITION CARE LLC
Active
Organization
HUMLIE MEDICAL NUTRITION CARE LLC
Active
Other names
Humlie Medical Nutrition Care
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE ANASTASIA HUMLIE RD, LD (OWNER)
(503) 883-1724
Entity
Organization
Contact information
Practice address
109 W 8TH ST, NEWBERG, OR 97132-4603
(503) 883-1724
(855) 966-4121
Mailing address
109 W 8TH ST, NEWBERG, OR 97132-4603
(503) 883-1724
(855) 966-4121
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10209651
LICENSE NUMBER
OR
Enumeration date
09/12/2020
Last updated
09/12/2020
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