Individual
MS. MARY K STANSELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD LD CDE
Contact information
Practice address
221 STEWART AVENUE, SUITE #101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 776-9833
Mailing address
221 STEWART AVENUE, SUITE #101, MEDFORD, OR 97501-3609
(541) 776-2003
(541) 776-9833
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
136
OR
Other
Enumeration date
06/04/2006
Last updated
07/08/2007
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