Organization Active NPI

Andria Clark RDN LLC

  • Registered Dietitian
  • Bend, OR
National Provider Identifier
1417806902
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
ANDRIA CLARK RDN LLC
Practice address
1900 NE 3Rd St Ste 106
Bend, OR 97701-3889
Phone
(206) 619-1553
NPI assigned
Jan 27, 2026
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Andria M Clark, MS, RDN, LDNPI 1376211797
Title
Registered Dietitian, Owner
Phone
(206) 619-1553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1900 NE 3Rd St Ste 106
Bend, OR 97701-3889

Mailing address

1900 NE 3Rd St Ste 106
Bend, OR 97701-3889
Phone (206) 619-1553

National Provider Directory

National Provider Directory

Locations

1900 NE 3rd St
Ste 106
Bend, OR 97701
Phone (206) 619-1553

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1417806902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 NE 3RD ST STE 106",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013889",
            "telephone_number": "206-619-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NE 3RD ST STE 106",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013889",
            "telephone_number": "206-619-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRIA CLARK RDN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ANDRIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN, OWNER",
        "authorized_official_telephone_number": "206-619-1553",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.