CAROLE L MATIACO (NPI# 1700149580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700149580 |
| Entity Type | Individual |
| Full Name | CAROLE L MATIACO |
| Credential | RD, LD |
| Practice Address |
15895 Sw 72nd Ave Suite 250 Bldg B Tigard OR 97224-7977 |
| Mailing Address |
15895 Sw 72nd Ave Suite 250 Tigard OR 97224-7977 |
| Practice Telephone | 5036245630 |
| Practice Fax Number | 5036249149 |
| Mailing Telephone | 5036245630 |
| Mailing Fax Number | 5036249149 |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2015-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 000965 | OR | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 5000662380 | 05 |
| Street Address |
15895 SW 72ND AVE SUITE 250 BLDG B |
| City | TIGARD |
| State | OR |
| Zip Code | 97224-7977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275147670 | Karina Ann Inouye | Dietitian, Registered | 13804 Sw Anna Ct, Tigard, OR 97223-2114 | 2020-09-02 |
| 1083979454 | Connie L Liakos | Dietitian, Registered | 7150 Sw Dartmouth St., Tigard, OR 97223 | 2012-07-11 |
| 1104442409 | Jessica Lynn Felly | Dietitian, Registered | 7358 Sw Durham Rd, Tigard, OR 97224-7307 | 2020-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902751 | Elise Michelle Edward | Dietitian, Registered | 5098 Sw Technology Loop Apt 205, Corvallis, OR 97333-1591 | 2020-11-06 |
| 1386245256 | Aloura Linfesty | Dietitian, Registered | 12944 Sw Sara Dr, Gaston, OR 97119-8580 | 2020-11-05 |
| 1699375394 | Ashlyn Hiserote | Dietitian, Registered | 7063 Se Horntail Ln, Hillsboro, OR 97123-2244 | 2020-10-30 |
| 1235739277 | Total Body Knowledge | Dietitian, Registered | 2314 Hempstead St Apt 3, Medford, OR 97501-0259 | 2020-10-29 |
| 1700484805 | Christine Charlotte Madzik | Dietitian, Registered | 655 E 43rd Ave, Eugene, OR 97405-3928 | 2020-10-12 |
| 1578160784 | Kristen Bowman | Dietitian, Registered | 749 Rabbit Run St, Stayton, OR 97383-1697 | 2020-10-01 |
| 1609483064 | Alayna Louise Hutchinson | Dietitian, Registered | 5258 Ne Cleveland Ave, Portland, OR 97211-2614 | 2020-09-29 |
| 1396350229 | Chelsea Elizabeth Horvath | Dietitian, Registered | 2831 Se Palmquist Rd Apt 153, Gresham, OR 97080-5276 | 2020-09-08 |
| 1720692007 | Gabrielle Anastasia Humlie | Dietitian, Registered | 109 W 8th St, Newberg, OR 97132 | 2020-09-03 |
| 1558973370 | Kianna Aumiller | Dietitian, Registered | 2167 Sw Yamhill St, Portland, OR 97205-1417 | 2020-08-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.