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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