Healthcare Provider Details

I. General information

NPI: 1700226230
Provider Name (Legal Business Name): NOURISHING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 06/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29965 SW BUCKHAVEN RD
HILLSBORO OR
97123-8822
US

IV. Provider business mailing address

1675 SW MARLOW AVE SUITE 301
PORTLAND OR
97225-5104
US

V. Phone/Fax

Practice location:
  • Phone: 503-830-4323
  • Fax:
Mailing address:
  • Phone: 503-384-0044
  • Fax: 503-384-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-D-000048
License Number StateOR

VIII. Authorized Official

Name: CLAUDIA J. KREFT
Title or Position: MANAGER
Credential: R.D. L.D.
Phone: 503-384-0044