Provider Demographics
NPI:1609207406
Name:ONCEA, SAREENA D (RD)
Entity Type:Individual
Prefix:MS
First Name:SAREENA
Middle Name:D
Last Name:ONCEA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SAREENA
Other - Middle Name:D
Other - Last Name:SMITH-BUCHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5211 NE GLISAN ST
Mailing Address - Street 2:BLDG C
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3052
Mailing Address - Country:US
Mailing Address - Phone:503-215-6628
Mailing Address - Fax:
Practice Address - Street 1:5211 NE GLISAN ST
Practice Address - Street 2:BLDG C
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3052
Practice Address - Country:US
Practice Address - Phone:503-215-6628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLD-D-10159487133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1068373OtherCOMMISSION ON DIETETIC REGISTRATION