Individual
LEANNE MICHELLE WITEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10803 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-3107
(503) 840-0671
(503) 566-6067
Mailing address
4130 SW 117TH AVE STE 473, BEAVERTON, OR 97005-5606
(503) 847-9952
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10200107
OR
Other
Enumeration date
02/27/2020
Last updated
09/21/2021
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