Individual
MRS. GABRIELLE ANASTASIA HUMLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
2435 NE CUMULUS AVE STE A, MCMINNVILLE, OR 97128-8805
(503) 472-6161
(503) 434-6290
Mailing address
2435 NE CUMULUS AVE STE A, MCMINNVILLE, OR 97128-8805
(503) 472-6161
(503) 434-6290
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10209651
OR
Other
Enumeration date
09/03/2020
Last updated
10/17/2021
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