Individual
KEELIE KORSNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSC, RDN, LD
Contact information
Practice address
260 SW MADISON AVE STE 109, CORVALLIS, OR 97333-4728
(545) 190-8731
Mailing address
26760 FUDGE RD, ALSEA, OR 97324-9412
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86017100
—
133V00000X
Registered Dietitian
LD-D-10192004
OR
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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