Individual
SUSAN MARIE WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
4540 NE GLISAN ST, PORTLAND, OR 97213-2333
(503) 215-5237
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10187943
OR
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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