Individual
MRS. TINA D GRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDE
Contact information
Practice address
480 NE A ST, MADRAS, OR 97741-1844
(541) 475-3882
(541) 475-0610
Mailing address
480 NE A ST, MADRAS, OR 97741-1844
(541) 475-3882
(541) 475-0610
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
00618978
DC
133VN1005X
Renal Nutrition Registered Dietitian
Primary
00618978
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00618978
ADA MEMBERSHIP
OR
05
—
151024
—
OR
Enumeration date
04/18/2008
Last updated
04/02/2010
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