Individual
LAURA CHRISTINE WULLSCHLEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
12123 SW 69TH AVE, PORTLAND, OR 97223-8514
(971) 708-7600
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
(360) 597-1313
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10208267
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86056281
COMMISSION ON DIETETIC REGISTRATION REGISTRATION ID NUMBER
CA
Enumeration date
11/16/2016
Last updated
05/14/2021
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