Individual
DONNA JEAN GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-4380
(503) 769-8563
Mailing address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-4380
(503) 769-8563
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
772
OR
Other
Enumeration date
01/30/2007
Last updated
10/24/2007
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