Gordanier, Jill Marie

Gordanier, Jill Marie is an individual health care provider with primary practice located at 1508 Division St Ste 15 , Oregon City OR 97045-1583. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Gordanier, Jill Marie can be contacted via phone (503) 692-3750.

Contact Information

Primary practice address
1508 Division St Ste 15 Oregon City OR 97045-1583
Phone: (503) 692-3750
Fax: (503) 691-2324
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X LD-D-10194419 Oregon

Profile Details

NPI number 1316511751
LBN Legal business name Gordanier, Jill Marie
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2021
Last updated Nov 22nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316511751 NPPES
Washington MEDICAID 2178242
Washington MEDICAID 500793387

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