Active NPI
Amanda Margolin
- Pediatric Nutrition Registered Dietitian
- Portland, OR
National Provider Identifier
1720533516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 10165396
- Practice address
- 9155 SW Barnes Rd
Suite 161
Portland, OR 97225-6625 - Phone
- (503) 216-8034
- NPI assigned
- Aug 22, 2016
- 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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 10165396 | OR | Primary |
Addresses
Primary practice location
9155 SW Barnes Rd
Suite 161
Portland, OR 97225-6625
Mailing address
9155 SW Barnes Rd
Suite 161
Portland, OR 97225-6625
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1720533516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD",
"address_2": "SUITE 161",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD",
"address_2": "SUITE 161",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256625",
"telephone_number": "503-216-8034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARGOLIN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "OR",
"license": "10165396",
"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 Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.