MLB NUTRITION & WELLNESS LLC NPI 1124397062

NPI Information

  • NPI: 1124397062
  • Provider Name: MLB NUTRITION & WELLNESS, LLC
  • Classification: Dietitian, Registered - 133VN1006X
  • Specialization: Nutrition, Metabolic
  • Entity Type: Organization
  • Address: 10101 SE MAIN ST
    PORTLAND, OR
    ZIP 97216
  • Phone: (917) 680-2820

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NPI Details

MLB NUTRITION & WELLNESS, LLC is a nutrition and metabolic dietitian registered in Portland, OR. The provider is a registered dietitian who achieves specialized competency in metabolic nutrition. MLB NUTRITION & WELLNESS, LLC NPI is 1124397062. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10101 SE MAIN ST
PORTLAND, OR
ZIP 97216-455
Phone: (917) 680-2820

The provider's authorized official is Melissa Lynn Bollman .
The authorized official title is President and has the following contact phone number (917) 680-2820.

The enumeration date for this NPI number is 12/21/2011 and was last updated on 12/21/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133VN1006XDietitian, RegisteredNutrition, MetabolicLDD10144515OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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