Marie Johnson

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

10180240 Issued in OR

Practice address

500 NE Multnomah St
Portland, OR 97232-2023

Phone

(503) 735-2727

NPI assigned

Nov 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1932641701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-313-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-735-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10180240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "500 NE Multnomah St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972322023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maggie Johnson, MT-BC
• Mallory Johnson, PEDIATRIC NP
• Marcie Marie Johnson, PAC
• Margaret Lillian Johnson, MSW
• Mariah Johnson, M.D.
• Marisa Protasel Johnson, PMHNP-BC
• Marisela Johnson
• Mark Johnson, DPT
• Marney Johnson, ND
• Marsha Ann Johnson, AU.D.

• Registered Dietitian in Portland, OR
• Providers in Portland, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.