Individual
KRISTY REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 E BURNSIDE ST, PORTLAND, OR 97214-1831
(503) 953-0310
Mailing address
7515 FALCON CREST DR # 200, REDMOND, OR 97756-5014
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L16422
OR
133N00000X
Nutritionist
—
—
Other
Enumeration date
01/18/2022
Last updated
05/12/2025
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