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General NPI Number Information
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NPI Number | 1174310049
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Entity Type | Individual
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Provider Name | KATHERINE ALDERMAN CLEM RD
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2525 NW LOVEJOY ST FL 3
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City | PORTLAND
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State | OR
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Zip | 97210-2859
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Country | US
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Telephone | 503-847-9952
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Fax |
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Provider Business Mailing Address
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Address Line | 7650 SW 140TH AVE
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City | BEAVERTON
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State | OR
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Zip | 97008-6158
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Country | US
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Telephone | 503-300-9802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD-D-10231346
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License Number State | OR
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