Active NPI
Angelika Zymelka, RD
- Registered Dietitian
- Portland, OR
National Provider Identifier
1639926975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-10237512
- Practice address
- 3530 SE 88TH Ave
Portland, OR 97266-2396 - Phone
- (503) 772-4335
- NPI assigned
- May 3, 2024
- Last updated
- May 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | D-10237512 | OR | Primary |
Addresses
Primary practice location
3530 SE 88TH Ave
Portland, OR 97266-2396
Mailing address
1130 SE Morrison St Apt 419
Portland, OR 97214-2596
Phone (954) 982-3258
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
| License | State | Type | Specialty |
|---|---|---|---|
| D-10237512 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1639926975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 SE MORRISON ST APT 419",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142596",
"telephone_number": "954-982-3258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 SE 88TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972662396",
"telephone_number": "503-772-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZYMELKA",
"first_name": "ANGELIKA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-03",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "D-10237512",
"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 3, 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.