Organization
THIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ESATTO (DIETITIAN, OWNER)
(503) 949-5499
Entity
Organization
Contact information
Practice address
1312 E BURNSIDE ST, PORTLAND, OR 97214-1424
(503) 949-5499
Mailing address
3824 SE 98TH AVE, PORTLAND, OR 97266-2502
(503) 949-5499
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10162720
OR
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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