Active NPI
Kathleen Marie Hefflinger, RD, LC, CDE
- Registered Dietitian
- Portland, OR
National Provider Identifier
1912974668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 605
- Practice address
- 1130 NW 22ND Ave
LL 10
Portland, OR 97210-2900 - Phone
- (503) 413-7311
- NPI assigned
- Mar 1, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 605 | OR | Primary |
Addresses
Primary practice location
1130 NW 22ND Ave
LL 10
Portland, OR 97210-2900
Mailing address
PO Box 4037
Portland, OR 97208-4037
Phone (503) 413-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8516023 | Medicaid | WA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 605 | OR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Good Samaritan Hospital and Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital Unit
- Portland, OR
- NPI 1336162874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1912974668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4037",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084037",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 NW 22ND AVE",
"address_2": "LL 10",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102900",
"telephone_number": "503-413-7311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEFFLINGER",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"credential": "RD, LC, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "605",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8516023",
"state": "WA"
}
],
"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 Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.