MEDICARE: MR. JEFFRY JAY SINANIAN I R.D., MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1447395942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFRY JAY SINANIAN I R.D., MPH

Provider Business Mailing Address
First Line	:	1631 NE BROADWAY ST STE 2174
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-1425
Country	:	US
Telephone Number	:	503-534-6178
Fax Number	:	503-534-6213

Provider Business Practice Location Address
First Line	:	1631 NE BROADWAY ST STE 2174
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-1425
Country	:	US
Telephone Number	:	206-941-1604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	05/14/2025

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