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NPI Code Detail

MEDICARE: MRS. CARLI WEBB M.S. HNFM

MEDICARE: MRS. CARLI WEBB M.S. HNFM
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
1133NN1002XNutrition Education NutritionistOR
2133N00000XNutritionistOR

General Provider Information

NPI Number : 1790296721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARLI WEBB M.S. HNFM
Provider Business Mailing Address
First Line : 2220 NW FRONT AVE APT 304
Second Line :
City : PORTLAND
State : OR
Zip : 97209-1998
Country : US
Telephone Number : 812-605-0749
Fax Number :
Provider Business Practice Location Address
First Line : 9320 SW BARBUR BLVD STE 165
Second Line :
City : PORTLAND
State : OR
Zip : 97219-5430
Country : US
Telephone Number : 503-545-6285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2017
Last Update Date : 03/17/2018

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