| Medical Nutrition Therapy Northwest | |
|
8800 Se Sunnyside Rd, Suite 224-south, Clackamas, OR 97015-5738 | |
| (503) 652-5070 | |
| (800) 957-1067 |
| Full Name | Medical Nutrition Therapy Northwest |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 8800 Se Sunnyside Rd, Clackamas, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275604399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | John Ellis Gobble |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1013919323 PECOS PAC ID: 2769577618 Enrollment ID: I20110331000071 |
| Provider Name | Rise Rafferty |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1912364662 PECOS PAC ID: 6608172093 Enrollment ID: I20160310002096 |
| Provider Name | Kendra Vos Becker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1639702954 PECOS PAC ID: 6406285097 Enrollment ID: I20200402001409 |
| Provider Name | Judy A. Sundquist |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538461603 PECOS PAC ID: 9133507551 Enrollment ID: I20220525002463 |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Nutrition Therapy Northwest 1463 Sw 20th Ct, Gresham, OR 97080-9662 Ph: (503) 652-5070 | Medical Nutrition Therapy Northwest 8800 Se Sunnyside Rd, Suite 224-south, Clackamas, OR 97015-5738 Ph: (503) 652-5070 |
Dr. John Ellis Gobble, DRPH, RD, LD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 8800 Se Sunnyside Rd, Suite 215-s, Clackamas, OR 97015 Phone: 503-652-5070 Fax: 800-957-1067 | |
Chelsea Lynn Jordan, RD, CDCES Dietitian Medicare: Medicare Enrolled Practice Location: 10151 Se Sunnyside Rd Ste 100, Clackamas, OR 97015 Phone: 503-659-0880 Fax: 503-513-7425 | |
Ms. Brenda Lou Buck, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 9900 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-571-3764 Fax: 503-571-8987 | |
Ms. Angela Koon Major, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 13568 Se 97th Ave, Clackamas, OR 97015 Phone: 503-652-5070 | |
Makenna Stafford, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 971-279-0963 | |
Stasha Anne Hornbeck, MS, RD, LD, CDE Dietitian Medicare: Medicare Enrolled Practice Location: 9800 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-571-3040 Fax: 503-571-3095 | |
Katherine Snyder, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10180 Se Sunnyside Road, Ksmc Nutrition Services, Clackamas, OR 97015 Phone: 503-571-4876 Fax: 503-571-6314 |