Individual
DENICE BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RYT200, BSW, MSCN
Contact information
Practice address
10512 SW LAUREL RD, BEAVERTON, OR 97005-3118
(503) 856-4507
Mailing address
10512 SW LAUREL RD, BEAVERTON, OR 97005-3118
(503) 856-4507
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
10/03/2017
Last updated
04/02/2025
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