MEDICARE: LILAC HINKIS

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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1770412314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILAC HINKIS

Provider Business Mailing Address
First Line	:	6313 SE WOODSTOCK BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-6650
Country	:	US
Telephone Number	:	949-245-4967
Fax Number	:

Provider Business Practice Location Address
First Line	:	6313 SE WOODSTOCK BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-6650
Country	:	US
Telephone Number	:	949-245-4967
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “ LILAC HINKIS ” Practice Location

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