Individual
AMY DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4578
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4578
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
892
OR
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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