Janelle M Bombara, RD
Individual provider Active NPI Registered Dietitian · Portland, OR
NPI 1245878552 · NPPES record last updated Sep 16, 2025
Key facts
- NPI
- 1245878552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- LD-D-10203087 (OR)
- Practice address
- 12360 E Burnside St
Portland, OR 97233-1042 - Phone
- (971) 279-4800
- Fax
- (971) 279-2051
- NPI assigned
- Dec 17, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250402002737 | OR | Practitioner - Registered Dietitian Or Nutrition Professional | 9739610478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD-D-10203087 | OR | MD | Registered Dietitian |
| DI60864552 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Native American Rehabilitation Assoc Inc | Current |
Accepting new patients | |
| Native American Rehabilitation Assoc Inc | Current |
Accepting new patients | |
| Native American Rehabilitation Assoc Inc | Past | Accepting new patients |
Locations
12360 E Burnside St
Portland, OR 97233
Phone (971) 279-4800
211 SE Caruthers St
Portland, OR 97214
Phone (503) 224-1044
1776 SW Madison St
Portland, OR 97205
Phone (503) 224-1044
703 NE Hancock St
Portland, OR 97212
Phone (503) 230-9875
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D-10203087 | OR | Yes |
| Registered Dietitian | 133V00000X | DI60864552 | WA |
Addresses
Primary practice location
12360 E Burnside St
Portland, OR 97233-1042
Mailing address
211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044
Other practice location 1
703 NE Hancock St
Portland, OR 97212-3955
Phone (503) 230-9875
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500773225 | Medicaid | OR | |
| 2147070 | Medicaid | WA |
Other providers in Portland, OR
- Danielle Boltz
- Jacqueline Elizabeth Boltz
- Boly Health and Education, LLC
- Hilarey Boly
- Frederick M Bolzendahl
- Despoina Bompolaki
- Bon Vivant Health and Wellness, LLC
- Catharine Ann Bon
- Maria Therese Bonacci
- Holly V Bonadurer
All providers in Portland, OR · Registered Dietitian in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.