NPI Code Details Logo

NPI 1659362119

NPI 1659362119 : ALISON J GOERL RD : PORTLAND, OR

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1659362119
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ALISON J GOERL RD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/03/2005
-----------------------------------------------------
    Last Update Date     |    07/29/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    703 NE HANCOCK ST 
-----------------------------------------------------
    City                 |    PORTLAND
-----------------------------------------------------
    State                |    OR
-----------------------------------------------------
    Zip                  |    97212-3955
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    503-230-9875
-----------------------------------------------------
    Fax                  |    503-331-3441
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    211 SE CARUTHERS ST 
-----------------------------------------------------
    City                 |    PORTLAND
-----------------------------------------------------
    State                |    OR
-----------------------------------------------------
    Zip                  |    97214-4502
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    503-224-1044
-----------------------------------------------------
    Fax                  |    971-260-0355
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    133V00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Dietitian
-----------------------------------------------------
    License Number       |    LD-D-000616
-----------------------------------------------------
    License Number State |    OR
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.