Individual
ALYSSA COLLEEN GORMALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-3926
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-3111
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10208663
OR
Other
Enumeration date
11/04/2021
Last updated
04/11/2023
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