Individual
MRS. ASHLEY BULLIE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., C.N.S.
Contact information
Practice address
2556 NW NORTHRUP STREET, PORTLAND, OR 97210-2684
(415) 404-1915
Mailing address
2556 NW NORTHRUP STREET, PORTLAND, OR 97210-2684
(415) 404-1915
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/03/2020
Last updated
08/21/2023
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