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General NPI Number Information
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NPI Number | 1720167638
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Entity Type | Individual
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Provider Name | MARY ARAKELIAN NORDLUND R.D.,C.D.E.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7201 N INTERSTATE AVE
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City | PORTLAND
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State | OR
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Zip | 97217-5523
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Country | US
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Telephone | 503-286-6816
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Fax |
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Provider Business Mailing Address
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Address Line | 3670 SE 150TH AVE
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City | PORTLAND
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State | OR
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Zip | 97236-2424
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Country | US
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Telephone | 503-760-8429
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | R394157
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License Number State | OR
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