Individual
TIFFANY A KERNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
5200 SW MACADAM AVE STE 580, PORTLAND, OR 97239-3837
(503) 231-7854
(503) 231-8153
Mailing address
5200 SW MACADAM AVE STE 580, PORTLAND, OR 97239-3837
(503) 231-7854
(503) 231-8153
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
448
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
448
DIETITIAN LICENSE
OR
01
—
861467
REGISTERED DIETITIAN
OR
Enumeration date
10/03/2006
Last updated
06/07/2016
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