Individual
ALYSSA MARIE O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1111 NE 99TH AVE, PORTLAND, OR 97220-9428
(503) 963-2707
(503) 963-2802
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
984417
—
133V00000X
Registered Dietitian
Primary
LD-D-10184454
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2086834
—
WA
05
—
500732181
—
OR
Enumeration date
12/07/2015
Last updated
07/21/2022
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