Provider Demographics
NPI:1487325445
Name:WEST, CLEO ALAIA (RD)
Entity type:Individual
Prefix:
First Name:CLEO
Middle Name:ALAIA
Last Name:WEST
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 SE HEIKE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-8237
Mailing Address - Country:US
Mailing Address - Phone:646-696-1096
Mailing Address - Fax:503-566-6067
Practice Address - Street 1:1700 NW 167TH PL STE 230
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4872
Practice Address - Country:US
Practice Address - Phone:800-424-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLD-D-10217067133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered