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Individual

MEGANN DASTRUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MDA

Contact information

Practice address
375 NW BEAVER ST, SUITE 101, PRINEVILLE, OR 97754-1802
(541) 447-0707
(541) 383-1883
Mailing address
600 SW COLUMBIA ST, SUITE 6210, BEND, OR 97702-1099
(541) 383-3005

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10176246
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
OR
Enumeration date
04/14/2016
Last updated
04/14/2016
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