NPI 1639880388 · live from the CMS NPI Registry
Carli D. Corpus
Dietitian, Registered in Bend, OR. National Provider Identifier 1639880388, active.
NPI record
| NPI | 1639880388 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2036 Ne Williamson Ct, Bend, OR 97701 |
| Practice phone | 541-706-6348 |
| Mailing address | 2245 W Trestle Dr, Meridian, ID 83646 |
| Enumerated | December 13, 2022 |
| Last updated | February 3, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.