IndividualActive
Gwen Stoolenwerk Waller, NTP
NPI 1164794350 · Nutritionist · Bend, OR
Gwen Stoolenwerk Waller, NTP is a Nutritionist provider in Bend, OR (NPI 1164794350).
Provider details
- NPI number
- 1164794350
- Entity type
- Individual
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Credential
- NTP
- Sex
- Female
- Sole proprietor
- Yes
Practice location
115 Se Craven Rd
Bend, OR 97702-1516
Phone: (541) 788-4469
Street-level locationGet directions
Mailing address
115 Se Craven Rd
Bend, OR 97702-1516
Registry dates
- Enumerated
- 2012-02-02
- Last updated
- 2012-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.