Individual
MRS. TRACY R SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, OHSU MAIL CODE: UHS 18, PORTLAND, OR 97239-3011
(503) 494-6160
(503) 494-3769
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU MAIL CODE: UHS 18, PORTLAND, OR 97239-3011
(503) 494-6160
(503) 494-3769
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/18/2007
Last updated
03/10/2011
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