Individual
MRS. DEANNE HILDE CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, MBA, LD
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
(503) 721-1050
Mailing address
6915 SE 68TH CT, HILLSBORO, OR 97123-6133
(503) 649-6134
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
92
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
564008
CDR
OR
01
—
92
LISCENSURE NUMBER
OR
Enumeration date
08/26/2006
Last updated
07/08/2007
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