Individual
ASHLEY L LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4578
(503) 494-3769
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4578
(503) 494-3769
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
854
OR
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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