Provider Demographics
NPI:1396029302
Name:BEHREND, ANNE (MS, RD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BEHREND
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 SW GAINES ST APT 28
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2987
Mailing Address - Country:US
Mailing Address - Phone:712-249-3891
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD # L103A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered