Provider Demographics
NPI:1144239468
Name:PADE, ALISON (RD)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:
Last Name:PADE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:MARGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:4413 SE JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5226
Mailing Address - Country:US
Mailing Address - Phone:503-349-5399
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR847902133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered