Individual
RENEE KATHRYN FAVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
342 FAIRVIEW ST, SILVERTON, OR 97381-1917
(503) 873-1518
Mailing address
4430 GREGORY CT SE, SALEM, OR 97302-4822
(971) 218-3630
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
LD-D-10158473
OR
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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