Individual
ANASTASIA KASIANCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CSSD
Contact information
Practice address
2955 NW MONTEREY DR, CORVALLIS, OR 97330-3434
(541) 257-5091
Mailing address
2955 NW MONTEREY DR, CORVALLIS, OR 97330-3434
(541) 619-1437
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10164889
OR
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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