Individual
KOHLEEN E ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CSR, LD
Contact information
Practice address
916 SW 17TH ST STE 100, REDMOND, OR 97756-2572
(541) 548-2778
Mailing address
916 SW 17TH ST STE 100, REDMOND, OR 97756-2572
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
LD-D10161414
OR
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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