Provider Demographics
NPI:1922841360
Name:FOR THE HEALTH OF IT NUTRITION LLC
Entity type:Organization
Organization Name:FOR THE HEALTH OF IT NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RDN
Authorized Official - Prefix:
Authorized Official - First Name:ESTEFANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:971-202-0352
Mailing Address - Street 1:16235 NW CANTON ST APT 303
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-1258
Mailing Address - Country:US
Mailing Address - Phone:971-202-0352
Mailing Address - Fax:
Practice Address - Street 1:16235 NW CANTON ST APT 303
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-1258
Practice Address - Country:US
Practice Address - Phone:971-202-0352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty