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General NPI Number Information
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NPI Number | 1487325445
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Entity Type | Individual
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Provider Name | CLEO ALAIA WEST RD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1700 NW 167TH PL STE 230
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City | BEAVERTON
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State | OR
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Zip | 97006-4872
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Country | US
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Telephone | 800-424-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 6135 SE HEIKE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-8237
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Country | US
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Telephone | 646-696-1096
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Fax | 503-566-6067
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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-10217067
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License Number State | OR
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