Individual
MS. LORI SUZANNE BRIZEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
516 SW 13TH ST, STE 101, BEND, OR 97702-3442
(541) 388-0694
Mailing address
516 SW13TH STREET STE 101, BEND, OR 97702
(541) 306-6801
(541) 312-4670
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
760
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8261778
—
WA
Enumeration date
07/23/2006
Last updated
10/18/2017
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