AMANDA KRISTINE FREDRICKSON


Address: 3611 Se 64th Ave., Portland, OR 97206
Phone: 5034948300

AMANDA KRISTINE FREDRICKSON (NPI# 1346852365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346852365
Entity Type Individual
Full Name AMANDA KRISTINE FREDRICKSON
Credential R.D.
Practice Address 3611 Se 64th Ave.
Portland
OR 97206
Practice Telephone 5034948300
Mailing Telephone 5034948300
Enumeration Date 2020-08-20
Last Update Date 2020-08-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered Dietary & Nutritional Service Providers

Office Location

Street Address 3611 SE 64TH AVE.
City PORTLAND
State OR
Zip Code 97206

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578108940 Amy Groulx Technician 5506 Se Mitchell St, Portland, OR 97206 2019-11-08
1477061265 Lisa Marie Matejka Naturopath 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 2018-01-16
1639625205 Mollie Kathleen Pence Registered Nurse 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 2016-09-01
1457709164 Lauren Murdoch Massage Therapist 4629 Southeast Woodstock Boulevard, Portland, OR 97206 2016-06-03
1962897785 Meigra Simon LLC Mechanotherapist 6842 Se Henry St, Portland, OR 97206 2015-03-30
1891186508 Teresa Leckron-myers Case Manager/Care Coordinator 7916 Se Foster Rd, Portland, OR 97206 2015-02-17
1831597590 Boey Yean Lim Acupuncturist 4629 Se Woodstock Blvd, Portland, OR 97206 2014-12-12
1295082329 Chase Heywood Price Acupuncturist 5425 Se Raymond Street, Portland, OR 97206 2012-08-08
1154678423 Annelise Sevastiana Schnase Counselor 4311 Se Woodstock Blvd, Portland, OR 97206 2012-08-06
1063774990 Molly A Norris Massage Therapist 6217 Se Harold St, Portland, OR 97206 2012-06-15
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Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609483064 Alayna Louise Hutchinson Dietitian, Registered 5258 Ne Cleveland Ave, Portland, OR 97211-2614 2020-09-29
1558973370 Kianna Aumiller Dietitian, Registered 2167 Sw Yamhill St, Portland, OR 97205-1417 2020-08-21
1255943189 Lisa Gilmore Dietitian, Registered 5214 Sw View Point Ter, Portland, OR 97239-3940 2020-08-21
1770192353 Jenice A Powell Dietitian, Registered 104 Se 30th Pl, Portland, OR 97214-1915 2020-07-29
1386253698 Margaret Senic Dietitian, Registered 1745 Sw Huntington Ave, Portland, OR 97225-4751 2020-07-23
1881212272 Emily Ryder Dietitian, Registered 624 Nw 20th Ave Apt 1, Portland, OR 97209-1219 2020-07-11
1427686211 Veena M Manohar Dietitian, Registered 1308 Ne Dekum St, Portland, OR 97211-4180 2020-03-29
1841825056 Allison Leigh Williams Dietitian, Registered 7106 Se Raymond Ct, Portland, OR 97206-4439 2020-03-08
1114557782 House Nine LLC Dietitian, Registered 1413 Se Hawthorne Blvd # 1, Portland, OR 97214-3640 2020-01-22
1437799061 Leslie Gildersleeve Bettencourt Dietitian, Registered 9427 Sw Barnes Rd Ste 390, Portland, OR 97225-6652 2020-01-11
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97206

Improve Information

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Dataset Information

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.

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