Individual provider Active NPI

Jaede Stank

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1255249207
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
30 NE Martin Luther King Blvd
Portland, OR 97232-2941
Phone
(503) 232-1099
NPI assigned
Aug 31, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

30 NE Martin Luther King Blvd
Portland, OR 97232-2941

Mailing address

3057 SW 173Rd Ave
Beaverton, OR 97003-5586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1255249207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 SW 173RD AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970035586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NE MARTIN LUTHER KING BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322941",
            "telephone_number": "503-232-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANK",
        "first_name": "JAEDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "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 Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.