Individual
BROOKE KATHLEEN BOSKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1750 NE NEFF RD, GUEST HOUSE, BEND, OR 97701-6111
(541) 980-7659
Mailing address
PO BOX 8815, BEND, OR 97708-8815
(541) 980-7659
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10177805
OR
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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