Individual
MR. BRICE WILLIAM SUPRENANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
16099 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-4680
(503) 922-2951
Mailing address
2023 SW RIVER SQ, PORTLAND, OR 97201-8017
(304) 639-2368
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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