Individual provider Active NPI

Cynthia Marie Easley, RD, LD, CDE

  • Registered Dietitian
  • Vancouver, WA
National Provider Identifier
1295074938
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60715721 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone
(360) 882-2778
Fax
(360) 604-1785
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-000489 OR
Registered Dietitian 133V00000X DI60715721 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-1913

Mailing address

PO Box 873010
Vancouver, WA 98687-3010
Phone (360) 882-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130927000198 OR Practitioner - Registered Dietitian Or Nutrition Professional 4385878677 Reassigns benefits to 1 organization
I20170215003078 WA Practitioner - Registered Dietitian Or Nutrition Professional 4385878677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD-D-000489ORMDRegistered Dietitian
DI60715721WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jan 16, 2017 Accepting new patients
Providence Health & Services - Oregon CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jan 16, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Providence Medical Group, PC Past Accepting new patients
Valeria Health, LLC Dietitian, Registered PastSince Dec 1, 2019 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

10330 SE 32nd Ave
Ste 305
Milwaukie, OR 97222
Phone (503) 408-4078

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9135 SW Barnes Rd
Ste 761
Portland, OR 97225
Phone (503) 216-2602

4400 NE Halsey St
Bldg 1
Portland, OR 97213
Phone (503) 215-6262

545 NE 47th Ave
Ste 102
Portland, OR 97213
Phone (503) 215-6262

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1295074938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 873010",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986873010",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-000489",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60715721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.