Balanced Nutrition NW LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BALANCED NUTRITION NW LLC

Practice address

20369 Homestead Dr
Oregon City, OR 97045-9012

Phone

(971) 419-8549

Fax

(971) 229-4024

NPI assigned

Jul 20, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victoria Padron, RD

Title

Registered Dietitian/Co-Owner

Phone

(971) 419-8549

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1912632266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20369 HOMESTEAD DR",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459012",
            "telephone_number": "971-419-8549",
            "fax_number": "971-229-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20369 HOMESTEAD DR",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970459012",
            "telephone_number": "971-419-8549",
            "fax_number": "971-229-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED NUTRITION NW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "PADRON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN/CO-OWNER",
        "authorized_official_telephone_number": "971-419-8549",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972131001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.