Individual
MEGAN ANTOSIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1040 NW 22ND AVE STE 520, PORTLAND, OR 97210
(503) 413-7557
(503) 413-6547
Mailing address
PO BOX 3808, PORTLAND, OR 97208-3808
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10150700
OR
Other
Enumeration date
10/29/2013
Last updated
05/22/2019
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