Provider Demographics
NPI:1649969809
Name:BARLOW, KRISTA RICHELLE (MSN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:RICHELLE
Last Name:BARLOW
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 NE EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-2407
Mailing Address - Country:US
Mailing Address - Phone:503-333-6605
Mailing Address - Fax:
Practice Address - Street 1:5809 NE EMERSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2407
Practice Address - Country:US
Practice Address - Phone:503-333-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist