Individual
AMANDA MARGOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9155 SW BARNES RD, SUITE 161, PORTLAND, OR 97225-6625
(503) 216-8034
Mailing address
9155 SW BARNES RD, SUITE 161, PORTLAND, OR 97225-6625
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
10165396
OR
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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