Individual
JANELLE M BOMBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DI60864552
WA
133V00000X
Registered Dietitian
Primary
LD-D-10203087
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2147070
—
WA
05
—
500773225
—
OR
Enumeration date
12/17/2019
Last updated
09/16/2025
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