Organization
LOVE OF LACTATION
Active
Organization
LOVE OF LACTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE VANDOMELEN RN, IBCLC (OWNER)
(503) 848-3483
Entity
Organization
Contact information
Practice address
20334 SW JAY ST, BEAVERTON, OR 97006-8026
(503) 848-3483
Mailing address
20334 SW JAY ST, BEAVERTON, OR 97006-8026
(503) 848-3483
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
200342213RN
OR
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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