Individual
JOSIE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
4805 NE GLISAN ST STE 6N40, PORTLAND, OR 97213-2933
(844) 987-0491
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDD10207742
OR
Other
Enumeration date
05/12/2020
Last updated
05/19/2020
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