Provider Demographics
NPI:1558973370
Name:AUMILLER, KIANNA (RDN)
Entity Type:Individual
Prefix:
First Name:KIANNA
Middle Name:
Last Name:AUMILLER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 SW YAMHILL ST APT 6
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1446
Mailing Address - Country:US
Mailing Address - Phone:406-241-7864
Mailing Address - Fax:
Practice Address - Street 1:2167 SW YAMHILL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1417
Practice Address - Country:US
Practice Address - Phone:406-241-7864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered