Individual
EMILY BUCCOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
8050 SE 13TH AVE, SUITE 204, PORTLAND, OR 97202-6694
(562) 256-6161
Mailing address
5331 SW MACADAM AVE, SUITE 258, PMB #535, PORTLAND, OR 97239-6104
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1080021
OR
Other
Enumeration date
09/06/2014
Last updated
09/06/2014
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