Samara Lily Roman-Holba, MS, EDM, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10217666 Issued in OR

Practice address

2143 NE Broadway St Ste 9
Portland, OR 97232-1512

Phone

(310) 906-8950

Fax

(855) 702-2328

NPI assigned

Nov 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• PNW Nutrition and Recovery

  • Clinic/Center
  • Portland, OR
  • NPI 1942059050
  NPD Authorized official

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1417612151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 NW PETTYGROVE ST APT 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102685",
            "telephone_number": "310-906-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 NE BROADWAY ST STE 9",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321512",
            "telephone_number": "310-906-8950",
            "fax_number": "855-702-2328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Abernethy Rd",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970451175",
            "country_code": "US",
            "telephone_number": "971-334-9380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN-HOLBA",
        "first_name": "SAMARA",
        "middle_name": "LILY",
        "credential": "MS, EDM, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10217666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy M Rollo, N.D., L.AC.
• David Lynn Rolph, R.PH.
• Rachel Rolph
• Rom Specialized Training, LLC
• Emily Rom, DO
• Chantal Marie Roman
• Edwin Rolando Roman
• Melanie Roman
• Rachael Anne Roman, LMT
• Ceann Romanaggi

• 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 May 23, 2025; 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.