Individual
MRS. LYDIA M MERRIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
830 NE 47TH AVE, PORTLAND, OR 97213-2212
(503) 215-2404
(503) 215-0056
Mailing address
830 NE 47TH AVENUE, PORTLAND, OR 97213-2212
(503) 215-2404
(503) 215-0056
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-000331
OR
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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