Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON THORUM, MS, RD, LD
ActivePediatric Nutrition · PORTLAND, OR
Registration Details
- NPI Number
- 1023366770
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 28, 2012 (13.649230331718 yrs)
- Last Updated
- Aug 28, 2012
- License
-
LDD10144588 (OR)
Practice Information
- Address
-
3181 SW SAM JACKSON PARK RDPORTLAND, OR, 972393011Browse OR providers · Browse ZIP 97239
- Phone
- 5034185257
- Fax
- 5034943769
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Other Pediatric Nutrition Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| MRS. PATRICIA A ROSE | RD,CSP,LD | 1376685883 |
| PAMELA JEAN KELLY HASKELL | RD, LD | 1962701565 |
| AUDREY EASTTUM | RD, CSP, LD | 1104125608 |
| MEGAN A JOHNSON | RD, LD | 1437443074 |
| JENNIFER S KIM | RD, LD | 1790079333 |
| JESSICA JOSEPHSON | RD, LD | 1093092983 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.