Laura Boehm, M.H.SC., R.D., L.D.
Individual provider Active NPI Registered Dietitian · Bend, OR
NPI 1396286704 · NPPES record last updated Feb 4, 2019
Key facts
- NPI
- 1396286704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- LD-D-000987 (OR)
- Practice address
- 19950 Pinewood Rd
Bend, OR 97702-2020 - Phone
- (541) 639-2004
- NPI assigned
- Mar 17, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 934298 | OR | MD | Registered Dietitian |
| LD-D-000987 | OR | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 934298 | OR | |
| Registered Dietitian | 133V00000X | LD-D-000987 | OR | Yes |
Addresses
Primary practice location
19950 Pinewood Rd
Bend, OR 97702-2020
Mailing address
19950 Pinewood Rd
Bend, OR 97702-2020
Phone (541) 639-2004
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.