Organization
KATIE ROGERS NUTRITION THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE ROGERS RDN, LD, CD (REGISTERED DIETITIAN/OWNER)
(479) 200-0581
Entity
Organization
Contact information
Practice address
2143 NE BROADWAY ST STE 9, PORTLAND, OR 97232-1512
(971) 259-3759
(971) 402-9020
Mailing address
607 SE 17TH AVE APT 7, PORTLAND, OR 97214-2600
(971) 259-3759
(971) 402-9020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841752292
NPI TYPE 1
—
01
—
LD-D-10186235
BOARD OF LICENSED DIETITIANS
OR
Enumeration date
10/31/2022
Last updated
10/31/2022
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