Provider Demographics
NPI:1275542771
Name:PORTER, MEGAN CM (RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CM
Last Name:PORTER
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N. GRAHM,
Mailing Address - Street 2:SUITE 375
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227
Mailing Address - Country:US
Mailing Address - Phone:503-413-1600
Mailing Address - Fax:503-413-1915
Practice Address - Street 1:501 N. GRAHM,
Practice Address - Street 2:SUITE 375
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227
Practice Address - Country:US
Practice Address - Phone:503-413-1600
Practice Address - Fax:503-413-1915
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR826924133V00000X
OR741133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered