Organization
ALAVITA PERINATAL NUTRITION ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA BOHNENGEL RD (OWNER, REGISTERED DIETITIAN)
(503) 407-2549
Entity
Organization
Contact information
Practice address
106 SW WOODS ST STE A, PORTLAND, OR 97201-4739
(503) 407-2549
Mailing address
4611 N KERBY AVE, PORTLAND, OR 97217-3043
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10159622
OR
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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