Individual
CASEY POSTMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11654 MT ANGEL GERVAIS RD NE, MOUNT ANGEL, OR 97362-9782
(503) 710-2065
Mailing address
PO BOX 916, MOUNT ANGEL, OR 97362-0916
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71400000X
OTHER
—
05
—
71400000X
—
OR
Enumeration date
04/15/2022
Last updated
04/15/2022
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