Individual provider Active NPI

Susan Evelyn Plaster, RDN

  • Registered Dietitian
  • Woodburn, OR
National Provider Identifier
1750115853
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-00968 Issued in OR
Practice address
1175 Mount Hood Ave
Woodburn, OR 97071-9060
Phone
(503) 982-2006
NPI assigned
Aug 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-00968 OR Primary

Addresses

Primary practice location

1175 Mount Hood Ave
Woodburn, OR 97071-9060

Mailing address

342 McLaughlin Dr
Woodburn, OR 97071-4510
Phone (503) 476-5591

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-00968ORMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1750115853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MCLAUGHLIN DR",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970714510",
            "telephone_number": "503-476-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MOUNT HOOD AVE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719060",
            "telephone_number": "503-982-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLASTER",
        "first_name": "SUSAN",
        "middle_name": "EVELYN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-00968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.