Individual provider Active NPI

Sandra L Moreno, RD

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1790375020
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
10181188 Issued in OR
Practice address
9427 SW Barnes Rd Ste 395
Portland, OR 97225-6652
Phone
(503) 216-6050
NPI assigned
Jan 20, 2021
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 10181188 OR Primary

Addresses

Primary practice location

9427 SW Barnes Rd Ste 395
Portland, OR 97225-6652

Mailing address

9427 SW Barnes Rd Ste 395
Portland, OR 97225-6652
Phone (503) 216-6050

Other practice location 1

1201 Court St NE Ste 310A
Salem, OR 97301-4182
Phone (503) 395-8890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251121000019 OR Practitioner - Registered Dietitian Or Nutrition Professional 0547752123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9427 SW Barnes Rd
Suite 395
Portland, OR 97225-6652
Phone (503) 216-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10181188ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
SLMC, LLC Dietitian, Registered CurrentSince Feb 13, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Oct 20, 2025 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 20, 2025 Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Ste 6N40
Portland, OR 97213
Phone (503) 215-5696

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9427 SW Barnes Rd
Ste 395
Portland, OR 97225
Phone (503) 216-2602

1201 Court St NE
Ste 310A
Salem, OR 97301
Phone (503) 395-8890

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1790375020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 395",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 395",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-6050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Court St NE Ste 310A",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014182",
            "country_code": "US",
            "telephone_number": "503-395-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10181188",
            "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 Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.