Gwen Stoolenwerk Waller, NTP

NPI #1164794350 in Bend, Oregon

Provider Information

NPI Number: 1164794350
Entity Type: Individual
Name: Gwen Stoolenwerk Waller, NTP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Nutritionist
Credential: NTP
Enumeration Date: Feb 2, 2012
Last Updated: Feb 2, 2012

Practice Location

Address: 115 SE CRAVEN RD
City: Bend
State: Oregon
ZIP Code: 97702-1516
Phone: (541) 788-4469

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist	133N00000X	Primary

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