Individual
ANDREA Q VINTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CSSD, LD
Contact information
Practice address
735 SW 158TH AVE # 160, BEAVERTON, OR 97006-4952
(503) 915-2555
Mailing address
2116 SW 19TH AVE, PORTLAND, OR 97201-2352
(503) 915-2555
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1029
OR
Other
Enumeration date
01/04/2011
Last updated
01/04/2011
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