Leanne Michelle Witek, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10200107 Issued in OR

Practice address

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107

Phone

(503) 840-0671

Fax

(503) 566-6067

NPI assigned

Feb 27, 2020

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

Enrolled in OR

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leanne@valeriamallett.com

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.

• Portland Clinic

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1558379099

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• South Tabor Family Physicians

  • Clinic/Center
  • Portland, OR
  • NPI 1982649299
  NPD (past)

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1982238069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 SW 117TH AVE STE 473",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970055606",
            "telephone_number": "503-847-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10803 SE CHERRY BLOSSOM DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163107",
            "telephone_number": "503-840-0671",
            "fax_number": "503-566-6067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9455 SW 80th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972238966",
            "country_code": "US",
            "telephone_number": "503-847-9952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITEK",
        "first_name": "LEANNE",
        "middle_name": "MICHELLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10200107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Leanne@valeriamallett.com",
            "affiliation": "N",
            "address_1": "10803 SE Cherry Blossom Dr",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972163107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Wisotzke
• Vanessa Rose Wissler
• Joanna Wiszniewska, M.D.
• Wojciech Krzysztof Wiszniewski, M.D.
• Kelly Witbeck, DNP, ARNP
• With Connection LLC
• With the Flow Psychotherapy, LLC
• Carolyn Marie Withee, DO
• Rebecca Witherow, LCSW
• April Katelle Withers, APRN

• 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 Sep 21, 2021; 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.