Individual provider Active NPI

Antoinette Eastwood, C.N.

  • Nutritionist
  • Tigard, OR
National Provider Identifier
1659764751
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
11930 SW Greenburg Rd
Tigard, OR 97223-6453
Phone
(503) 639-3777
NPI assigned
Mar 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X Primary

Addresses

Primary practice location

11930 SW Greenburg Rd
Tigard, OR 97223-6453

Mailing address

14778 NW Vance Dr
Portland, OR 97229-9267

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

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1659764751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14778 NW VANCE DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972299267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 SW GREENBURG RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236453",
            "telephone_number": "503-639-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTWOOD",
        "first_name": "ANTOINETTE",
        "credential": "C.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.