Individual
ELLIE NAGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 SW 9TH ST, ONTARIO, OR 97914-2639
(541) 881-7192
(541) 881-7147
Mailing address
351 SW 9TH ST, ONTARIO, OR 97914-2639
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-831
ID
133V00000X
Registered Dietitian
LD-D-10164583
OR
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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