Individual
JAMIE MENZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCN, CNS, CN, LD
Contact information
Practice address
4110 SE HAWTHORNE BLVD, #103, PORTLAND, OR 97214-5246
(503) 894-6619
Mailing address
4110 SE HAWTHORNE BLVD, #103, PORTLAND, OR 97214-5246
(503) 894-6619
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
LD-D-10240823
OR
133N00000X
Nutritionist
NU61466525
WA
Other
Enumeration date
08/03/2023
Last updated
06/27/2024
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