Deanne Hilde Carlisle, RD, MBA, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

92 Issued in OR

Practice address

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964

Phone

(503) 220-8262

Fax

(503) 721-1050

NPI assigned

Aug 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194833681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 SE 68TH CT",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971236133",
            "telephone_number": "503-649-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262",
            "fax_number": "503-721-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "DEANNE",
        "middle_name": "HILDE",
        "name_prefix": "Mrs.",
        "credential": "RD, MBA, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR",
            "identifier": "564008",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSURE NUMBER",
            "identifier": "92",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mekayla R Carlen, RD
• Karen M Carleton, N.D.
• Sarah Christine Carleton
• Kai Deva Carli, MA AT, ATR-P
• Jessica Carlin
• James R Carlisle, MD
• Cody Carlman
• Carlos Ceballos, MD
• Kristi Carlough, LMT
• Adrienne Marie Carlson, DPT

• Registered Dietitian in Portland, OR
• Providers in Portland, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.