Individual provider Active NPI

Mai Luong, R.D

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1487064028
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
805464 Issued in OR
Practice address
1320 SW Washington St
Portland, OR 97205-2327
Phone
(503) 535-1177
Fax
(503) 535-1191
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2014

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 805464 OR Primary

Addresses

Primary practice location

1320 SW Washington St
Portland, OR 97205-2327

Mailing address

1320 SW Washington St
PO Box 3007
Portland, OR 97205-2327
Phone (503) 535-1177

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
805464ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Depaul Treatment Centers Inc Past Accepting new patients
Fora Health Inc. PastSince Jul 31, 2022 Accepting new patients

Organizations & group practices 2

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": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1487064028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SW WASHINGTON ST",
            "address_2": "PO BOX 3007",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1177",
            "fax_number": "503-535-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1177",
            "fax_number": "503-535-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "MAI",
        "name_prefix": "Mrs.",
        "credential": "R.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "805464",
            "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 May 5, 2014; 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.