Healthcare Provider Details

I. General information

NPI: 1598074288
Provider Name (Legal Business Name): CATALINA VLAD MS,RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5935 WILLOW LN
LAKE OSWEGO OR
97035-5344
US

IV. Provider business mailing address

15241 NE BROADWAY ST
PORTLAND OR
97230-4646
US

V. Phone/Fax

Practice location:
  • Phone: 503-655-0044
  • Fax:
Mailing address:
  • Phone: 503-679-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1004
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: