Individual
MRS. MAI LUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D
Contact information
Practice address
1320 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1177
(503) 535-1191
Mailing address
1320 SW WASHINGTON ST, PO BOX 3007, PORTLAND, OR 97205-2327
(503) 535-1177
(503) 535-1191
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
805464
OR
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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