Provider Demographics
NPI:1154910867
Name:ABRAMS, ISABELLE (MSCP, BA NUTR)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:MSCP, BA NUTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 NE JANICE WAY
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6689
Mailing Address - Country:US
Mailing Address - Phone:510-603-0486
Mailing Address - Fax:
Practice Address - Street 1:1770 NE JANICE WAY
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6689
Practice Address - Country:US
Practice Address - Phone:510-603-0486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORNA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist