OrganizationActive
Modern Nutrition Nw LLC
NPI 1235769670 · Health Service Clinic/Center · Portland, OR
Provider details
- NPI number
- 1235769670
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Krista Schaefer, Registered Dietitian Nutritionist(503) 313-6461
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7003 Se Yearling Ln
Portland, OR 97267-1983
Phone: (503) 650-3801
Fax: (503) 650-7002
Street-level locationGet directions
Mailing address
Po Box 493
Clackamas, OR 97015-0493
Registry dates
- Enumerated
- 2020-01-24
- Last updated
- 2025-08-26
- Certified
- 2025-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.