Individual
JAMIE MELINDA LIBERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2453
Mailing address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2453
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10145131
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1087488
CDR
OR
Enumeration date
01/23/2017
Last updated
01/23/2017
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