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Individual

MRS. PATRICIA JEAN REGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, CD, LD

Contact information

Practice address
72 SE 47TH CIR, GRESHAM, OR 97080-6403
(503) 926-4647
Mailing address
72 SE 47TH CIR, GRESHAM, OR 97080-6403
(503) 926-4647

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
819
OR
133V00000X
Registered Dietitian
D100001708
WA

Other

Enumeration date
11/11/2008
Last updated
08/12/2011
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