NPIMap

Organization Active NPI

Eat Well Nutrition Counseling, LLC

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1508759960
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EAT WELL NUTRITION COUNSELING, LLC
Practice address
42 NE Tillamook St Unit a
Portland, OR 97212-4175
Phone
(206) 755-8047
NPI assigned
Jun 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Amanda Fredrickson, RDNPI 1346852365
Title
Owner, Registered Dietitian
Phone
(206) 755-8047

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

42 NE Tillamook St Unit a
Portland, OR 97212-4175

Mailing address

42 NE Tillamook St Unit a
Portland, OR 97212-4175
Phone (206) 755-8047

National Provider Directory

National Provider Directory

Locations

42 NE Tillamook St
Unit A
Portland, OR 97212
Phone (206) 755-8047

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1508759960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NE TILLAMOOK ST UNIT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972124175",
            "telephone_number": "206-755-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NE TILLAMOOK ST UNIT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972124175",
            "telephone_number": "206-755-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAT WELL NUTRITION COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "FREDRICKSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "206-755-8047",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Jun 2, 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.