Provider Demographics
NPI:1669750642
Name:COATE-HERMES, ANGELA BRIANA (RDN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:BRIANA
Last Name:COATE-HERMES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 SW HALL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005
Mailing Address - Country:US
Mailing Address - Phone:503-643-0892
Mailing Address - Fax:503-336-1004
Practice Address - Street 1:4530 SW HALL BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-0504
Practice Address - Country:US
Practice Address - Phone:503-643-0892
Practice Address - Fax:503-336-1004
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered