Brooke Kathleen Boskovich, RD
Dietitian, Registered in Bend, OR. Individual provider (NPI-1).
NPI number1477095370
StatusActive
Last updated in NPPESNov 8, 2016
Details
- NPI
- 1477095370
- Entity type
- Individual (NPI-1)
- Name
- Brooke Kathleen Boskovich
- Credential
- RD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 8, 2016
- Last updated
- Nov 8, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | LD-D-10177805 | OR | Yes |
Other names
- Brooke Kathleen Gray (Former Name)
Practice location
1750 Ne Neff RdGuest House
Bend, OR 97701-6111
Phone 541-980-7659
Mailing address
Po Box 8815Bend, OR 97708-8815
Phone 541-980-7659
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