Healthcare Provider Details

I. General information

NPI: 1780608372
Provider Name (Legal Business Name): CHRISTIN MARIE BREGMAN R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 SW US VETERANS HOSPITAL RD PFNFS
PORTLAND OR
97239-2964
US

IV. Provider business mailing address

PO BOX 2514
BATTLE GROUND WA
98604-2514
US

V. Phone/Fax

Practice location:
  • Phone: 503-220-8262
  • Fax: 503-721-1050
Mailing address:
  • Phone: 360-686-3708
  • Fax: 503-721-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: