Individual
CARLY KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, LD
Contact information
Practice address
2329 NW ASPEN AVE, PORTLAND, OR 97210-1220
(503) 899-9712
Mailing address
2329 NW ASPEN AVE, PORTLAND, OR 97210-1220
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10165037
OR
Other
Enumeration date
09/05/2014
Last updated
08/27/2020
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