Caitlin Carr, RD, CDCES
Dietitian, Registered in Portland, OR. Individual provider (NPI-1).
NPI number1104534643
StatusActive
Last updated in NPPESJul 10, 2025
Details
- NPI
- 1104534643
- Entity type
- Individual (NPI-1)
- Name
- Caitlin Carr
- Credential
- RD, CDCES
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 14, 2022
- Certification date
- Jul 10, 2025
- Last updated
- Jul 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 10217394 | OR | Yes |
| 174400000X | Specialist | 32308621 | – |
Practice location
19500 Se Stark StPortland, OR 97233-5757
Phone 410-960-5120
Mailing address
1806 Hall CtWest Linn, OR 97068-4124
Phone 410-960-5120
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