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Individual

MEGAN DERAS GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CNS

Contact information

Practice address
1585 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5178
(503) 548-4008
Mailing address
2990 SW WEST POINT AVE, PORTLAND, OR 97225-3377
(503) 515-8069

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary

Other

Enumeration date
05/17/2017
Last updated
05/17/2017
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