Individual
LESLIE GILDERSLEEVE BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
9427 SW BARNES RD STE 390, PORTLAND, OR 97225-6652
(503) 215-7230
Mailing address
2981 NW 110TH TER, PORTLAND, OR 97229-4662
(610) 392-8731
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10187701
OR
Other
Enumeration date
01/11/2020
Last updated
01/11/2020
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