Individual
DIANNE MARIE DENOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSG, LD
Contact information
Practice address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-3484
Mailing address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-3484
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD-D-10176117
OR
133VN1101X
Gerontological Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
10/25/2019
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