BREANNA WILSON (NPI# 1760737837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760737837 |
| Entity Type | Individual |
| Full Name | BREANNA WILSON |
| Credential | MS, RD, LD |
| Practice Address |
612 Sw 25th Cir Troutdale OR 97060-1891 |
| Practice Telephone | 7752303787 |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | LD-D-10167267 | OR | Dietary & Nutritional Service Providers |
| Y | 133V00000X | Dietitian, Registered | 1003583 | OR | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | 1003583 | VA | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023527488 | Breanna Lynn Wilson | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-09-28 |
| Street Address |
612 SW 25TH CIR |
| City | TROUTDALE |
| State | OR |
| Zip Code | 97060-1891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780217018 | Cmb Nutrition & Wellness | Dietitian, Registered | 612 Sw 25th Cir, Troutdale, OR 97060-1891 | 2020-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861921124 | Kayla Michelle Stewart | Doula | 424 Se 19th St, Troutdale, OR 97060 | 2017-06-08 |
| 1467856955 | Meghan Ellen Revoir Bennett | Naturopath | 330 Se 3rd Street, Troutdale, OR 97060 | 2014-10-13 |
| 1699012310 | Scott C Williams | Pharmacist | 22855 N.e. Parklane, Wood Village, OR 97060 | 2013-01-15 |
| 1285888636 | Dan E. Cox | Counselor | 107 E. Historic Columbia River Hwy, Suite 207, Troutdale, OR 97060 | 2008-11-12 |
| 1356592596 | Emily J White | Pulmonary Function Technologist | 735 Sw 14th St, Troutdale, OR 97060 | 2008-10-07 |
| 1497905772 | Fred Meyer | Pharmacist | 22855 Ne Parklane, Wood Village, OR 97060 | 2008-09-24 |
| 1104072057 | Sharon Brennan | Nurse Practitioner | 2800 Sw 257th Avenue, Columbia View Family Health Center, Troutdale, OR 97060 | 2008-08-12 |
| 1902094386 | Steven Gary Cranford | Chiropractor | 1530 Sw 257th Dr., Troutdale, OR 97060 | 2007-10-10 |
| 1750581062 | Gresham-troutdale Family Medical Center | Non-Pharmacy Dispensing Site | 1700 Sw 27th Ave, Troutdale, OR 97060 | 2007-07-24 |
| 1710181755 | Valerie Kay Robertson | Specialist | 3703 Se 39th, Portland, OR 97060 | 2007-06-13 |
| Find all providers in zip 97060 | ||||
| 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 |
|---|---|---|---|---|
| 1780217018 | Cmb Nutrition & Wellness | Dietitian, Registered | 612 Sw 25th Cir, Troutdale, OR 97060-1891 | 2020-02-14 |
| 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 |
| 1275147670 | Karina Ann Inouye | Dietitian, Registered | 13804 Sw Anna Ct, Tigard, OR 97223-2114 | 2020-09-02 |
| 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.