Individual
NICOLE ALYSSA LAFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3095
(503) 241-5090
Mailing address
3101 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3095
(503) 241-5090
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10252351
OR
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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