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General NPI Number Information
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NPI Number | 1639926975
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Entity Type | Individual
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Provider Name | ANGELIKA ZYMELKA RD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 3530 SE 88TH AVE
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City | PORTLAND
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State | OR
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Zip | 97266-2396
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Country | US
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Telephone | 503-772-4335
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 SE MORRISON ST APT 419
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City | PORTLAND
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State | OR
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Zip | 97214-2596
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Country | US
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Telephone | 954-982-3258
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D-10237512
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License Number State | OR
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