Provider Demographics
NPI:1780608372
Name:BREGMAN, CHRISTIN MARIE (RD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:MARIE
Last Name:BREGMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2514
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-2514
Mailing Address - Country:US
Mailing Address - Phone:360-686-3708
Mailing Address - Fax:503-721-1050
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:PFNFS
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-721-1050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA719409OtherDIETETIC REGISTRATION