Active NPI
Janet Lee Muckridge, RD LD
- Registered Dietitian
- Portland, OR
National Provider Identifier
1013199694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 737
- Practice address
- 3550 N Interstate Ave
Nutrition Department East Interstate
Portland, OR 97227-1196 - Phone
- (503) 286-6871
- NPI assigned
- Dec 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 737 | OR | Primary |
Addresses
Primary practice location
3550 N Interstate Ave
Nutrition Department East Interstate
Portland, OR 97227-1196
Mailing address
3550 North Interstate Avenue
Nutrition Department East Interstate
Portland, OR 97227-1097
Phone (503) 286-6871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 737 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1013199694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 NORTH INTERSTATE AVENUE",
"address_2": "NUTRITION DEPARTMENT EAST INTERSTATE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271097",
"telephone_number": "503-286-6871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 N INTERSTATE AVE",
"address_2": "NUTRITION DEPARTMENT EAST INTERSTATE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271196",
"telephone_number": "503-286-6871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCKRIDGE",
"first_name": "JANET",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "RD LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-05",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.