Rebecca Rose Buck Douville, MS

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

5120 SW Richardson Dr
Portland, OR 97239-2054

Phone

(206) 390-0747

NPI assigned

May 10, 2023

Last updated

May 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Osa Integrative Health

  • Health Service Clinic/Center
  • Portland, OR
  • NPI 1831918481
  NPD Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1770273971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 SW RICHARDSON DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392054",
            "telephone_number": "206-390-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 SW RICHARDSON DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392054",
            "telephone_number": "206-390-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK DOUVILLE",
        "first_name": "REBECCA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Buchholz, OTR/L
• Katherine Anne Buchholz, LMFT
• Mark T Buchholz, MD
• Kyle Robert Buchwalder, MD
• Maria Blanca Bucio, NP
• Brittany Lynn Buck
• Cindy Buck
• Gail Buck
• Jerry Allen Buck III
• Joseph M Buck, PA-C

• Nutritionist in Portland, OR
• Providers in Portland, OR by specialty
• Nutritionist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.