Angela Bublik

Primary specialty

NutritionistTaxonomy code 133N00000X

License

NU60903817 Issued in WA

Practice address

5506 SE Lexington St
Portland, OR 97206-9024

Phone

(971) 313-3778

NPI assigned

Jan 13, 2021

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1053900043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 SE LEXINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972069024",
            "telephone_number": "971-313-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5506 SE LEXINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972069024",
            "telephone_number": "971-313-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBLIK",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU60903817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Thomas Bryson, CADC I, CRM
• Frances Bubalo
• Joseph Stephen Bubalo
• Katrina Bubas Stevens, CPM, LDM
• Irvan Bubic, MD
• Melissa Beth Buboltz, M.D.
• Katherine Bucciantini, AGPCNP, ANP
• Emily Buccola, RD
• Faith Buchanan, M.A.
• Isaiah Buchanan, COTA/L

• Nutritionist in Portland, OR
• Providers in Portland, OR by specialty
• Nutritionist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.