Individual
TINA L MATAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NTP
Contact information
Practice address
115 W GLOUCESTER ST, GLADSTONE, OR 97027-2032
(503) 303-8153
Mailing address
29061 SE HIGHWAY 224, EAGLE CREEK, OR 97022-9719
(503) 303-8153
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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