| Alyssa Marie O'brien, RD | |
|
1111 Ne 99th Ave, Portland, OR 97220-9428 | |
| (503) 963-2707 | |
| (503) 963-2802 |
| Full Name | Alyssa Marie O'brien |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1111 Ne 99th Ave, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023483799 | NPI | - | NPPES |
| 2086834 | Medicaid | WA | |
| 500732181 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 984417 (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | LD-D-10184454 (Oregon) | Primary |
| Provider Name | Gi Nutrition Nw, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1427632884 PECOS PAC ID: 7911395348 Enrollment ID: O20211103002566 |
| Mailing Address | Practice Location Address |
|---|---|
| Alyssa Marie O'brien, RD 847 Ne 19th Ave Ste 300, Portland, OR 97232-2686 Ph: (503) 963-2801 | Alyssa Marie O'brien, RD 1111 Ne 99th Ave, Portland, OR 97220-9428 Ph: (503) 963-2707 |
Kara Marie Odiaga, RD, CSR, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 703 Ne Hancock St, Portland, OR 97212 Phone: 503-493-3322 Fax: 503-287-9434 | |
Mrs. April D Mitsch, RD Dietitian Medicare: Medicare Enrolled Practice Location: 700 Sw Campus Dr, Portland, OR 97239 Phone: 503-494-8362 Fax: 503-494-4447 | |
Julie Marie Martin, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-5466 | |
Alavita Perinatal Nutrition Associates, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 106 Sw Woods St Ste A, Portland, OR 97201 Phone: 503-407-2549 | |
Jennifer Christine Kainani Ching, RD Dietitian Medicare: Medicare Enrolled Practice Location: 3530 Se 88th Ave, Portland, OR 97266 Phone: 503-772-4335 Fax: 503-772-4337 | |
Mary Ann Weinberg, RD, CNSD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-7597 | |
Ms. Janet Lee Muckridge, RD LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Nutrition Department East Interstate, Portland, OR 97227 Phone: 503-286-6871 |