Provider Demographics
NPI:1053681338
Name:MAJOR, ANGELA KOON (RD)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KOON
Last Name:MAJOR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3561 HANSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7813
Mailing Address - Country:US
Mailing Address - Phone:509-727-7987
Mailing Address - Fax:
Practice Address - Street 1:13568 SE 97TH AVE
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6670
Practice Address - Country:US
Practice Address - Phone:503-652-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered