Individual
MICHELLE TEGENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-3759
(503) 494-3769
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-3759
(503) 494-3769
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
923
OR
Other
Enumeration date
01/05/2010
Last updated
01/05/2010
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