Healthcare Provider Details

I. General information

NPI: 1346612108
Provider Name (Legal Business Name): COURTNEY MARQUES TURK R.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY MARQUES R.D.N.

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 N INTERSTATE AVE
PORTLAND OR
97227-1196
US

IV. Provider business mailing address

19985 SW LUREE ST
BEAVERTON OR
97003-2149
US

V. Phone/Fax

Practice location:
  • Phone: 503-201-7994
  • Fax:
Mailing address:
  • Phone: 630-267-1883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86038897
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: