Individual
ANGELA BUBLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5506 SE LEXINGTON ST, PORTLAND, OR 97206-9024
(971) 313-3778
Mailing address
5506 SE LEXINGTON ST, PORTLAND, OR 97206-9024
(971) 313-3778
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NU60903817
WA
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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