Eat Heal Nourish LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

EAT HEAL NOURISH LLC

Practice address

14631 SW Millikan Way
Beaverton, OR 97003-2999

Phone

(503) 890-5139

NPI assigned

Dec 3, 2024

Organization subpart

No

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

Authorized official

Name

Koosje Boyd

Title

Dietitian

Phone

(503) 890-5139

Specialties & licenses 1

Addresses

Other names 1

• Eat Heal Nourish Other name

Locations

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1497561625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SW CEDAR HILLS BLVD # 2250",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051354",
            "telephone_number": "503-890-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14631 SW MILLIKAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970032999",
            "telephone_number": "503-890-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAT HEAL NOURISH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KOOSJE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "503-890-5139"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eat Heal Nourish",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Eat Heal Nourish",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Registered Dietitian in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.