Individual
MELANIE AILENE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
17727 E BURNSIDE ST, PORTLAND, OR 97233-4803
(503) 215-9800
(503) 215-9810
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-000636
OR
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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