NPIMap

Organization Active NPI

Portland Pediatric Nutrition

  • Registered Dietitian
  • Portland, OR
National Provider Identifier
1972012409
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-000479 Issued in OR
Legal business name
PORTLAND PEDIATRIC NUTRITION
Practice address
1730 SW Skyline Blvd Ste 226
Portland, OR 97221-2549
Phone
(971) 319-1288
NPI assigned
Sep 27, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mrs. Katharine Burton Jeffcoat, RDN, LD, CLTNPI 1710369178
Title
Dietitian/Owner
Phone
(503) 997-8897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X LD-D-000479 OR Primary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X DI60717826 WA
Pediatric Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133VN1004X LD-D-000479 OR

Addresses

Primary practice location

1730 SW Skyline Blvd Ste 226
Portland, OR 97221-2549

Mailing address

3230 SW Gale Ave
Portland, OR 97239-1450
Phone (503) 997-8897

Other practice location 1

717 NE 61st St Ste 202
Vancouver, WA 98665-8756
Phone (971) 319-1288

National Provider Directory

National Provider Directory

Locations

70 SW Century Dr
Bend, OR 97702
Phone (541) 419-3785

1730 SW Skyline Blvd
Ste 226
Portland, OR 97221
Phone (503) 512-9198

4850 SW Scholls Ferry Rd
Ste 205
Portland, OR 97225
Phone (503) 252-3801

19365 SW 65th Ave
Ste 110
Tualatin, OR 97062

101 E 8th St
Ste 260
Vancouver, WA 98660
Phone (360) 524-6127

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1972012409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 SW GALE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391450",
            "telephone_number": "503-997-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 SW SKYLINE BLVD STE 226",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212549",
            "telephone_number": "971-319-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 NE 61st St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986658756",
            "country_code": "US",
            "telephone_number": "971-319-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PORTLAND PEDIATRIC NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "JEFFCOAT",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "BURTON",
        "authorized_official_title_or_position": "DIETITIAN/OWNER",
        "authorized_official_telephone_number": "503-997-8897",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN, LD, CLT"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-000479",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60717826",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "OR",
            "license": "LD-D-000479",
            "primary": false
        }
    ],
    "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 Mar 17, 2018; 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.