Individual
CANDACE LYNNE COLLEKNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCN
Contact information
Practice address
17712 SW 81ST PL, PORTLAND, OR 97224-7671
(503) 702-2388
Mailing address
17712 SW 81ST PL, PORTLAND, OR 97224-7671
(503) 702-2388
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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