Individual
MRS. JANE MARIE GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
18380 WILLAMETTE DR, WEST LINN, OR 97068-1200
(503) 697-4171
(503) 697-1002
Mailing address
18380 WILLAMETTE DR, WEST LINN, OR 97068-1200
(503) 697-4171
(503) 697-1002
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
328032
IL
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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