Provider Demographics
NPI:1235526286
Name:MORELLO, HOLLY LYNN (NTP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LYNN
Last Name:MORELLO
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3874 NW LORIANN DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-8346
Mailing Address - Country:US
Mailing Address - Phone:971-279-8181
Mailing Address - Fax:
Practice Address - Street 1:3874 NW LORIANN DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-8346
Practice Address - Country:US
Practice Address - Phone:971-279-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist