Individual provider Active NPI

Liat Nadler, MSCN

  • Registered Dietitian
  • North Plains, OR
National Provider Identifier
1538769146
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10224135 Issued in OR
Practice address
11285 NW 317TH PL
North Plains, OR 97133-6219
Phone
(503) 899-8204
NPI assigned
Nov 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Registered Dietitian 133V00000X LD-D-10224135 OR Primary

Addresses

Primary practice location

11285 NW 317TH PL
North Plains, OR 97133-6219

Mailing address

11285 NW 317TH PL
North Plains, OR 97133-6219
Phone (503) 899-8204

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
LD-D-10224135ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fabulous Healing Nutrition & Wellness LLC Nutritionist CurrentSince Feb 21, 2021 Accepting new patients

Locations

2232 NW Pettygrove St
Ste 110
Portland, OR 97210
Phone (503) 224-4804

Organizations & group practices 1

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": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1538769146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 NW 317TH PL",
            "city": "NORTH PLAINS",
            "state": "OR",
            "postal_code": "971336219",
            "telephone_number": "503-899-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11285 NW 317TH PL",
            "city": "NORTH PLAINS",
            "state": "OR",
            "postal_code": "971336219",
            "telephone_number": "503-899-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADLER",
        "first_name": "LIAT",
        "credential": "MSCN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10224135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Plains, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.