Individual
CORLEEN ANGELA BANTUGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9155 SW BARNES RD, SUITE 435, MEDICAL OFFICE BUILDING #3, PORTLAND, OR 97225-6625
(503) 216-1234
Mailing address
9155 SW BARNES RD, SUITE 435, MEDICAL OFFICE BUILDING #3, PORTLAND, OR 97225-6625
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
OR
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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