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General NPI Number Information
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NPI Number | 1396460598
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Entity Type | Organization
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Legal Business Name | THE MINDFUL RDN, LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 3125B NE HOLLADAY ST
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City | PORTLAND
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State | OR
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Zip | 97232-2504
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Country | US
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Telephone | 971-361-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 420 NE BIRCH ST APT 206
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City | CAMAS
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State | WA
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Zip | 98607-2162
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN/CONSULTANT
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Name | BROOKE SEIBERT
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Credential | RDN
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Telephone | 971-361-8250
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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 |
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License Number State |
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