Individual
KATHERINE A BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSO, LD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-9731
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000981
OR
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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