IndividualActive
Chanel Clark, RDN, LD
NPI 1609424183 · Registered Dietitian · Indian Valley, ID
Provider details
- NPI number
- 1609424183
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- RDN, LD
- Sex
- Female
- Sole proprietor
- Yes
- License
- D-859 (ID)
Specialties & taxonomies
Dietary & Nutritional Service Providers
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
2278 Moritz Ln
Indian Valley, ID 83632-5019
Phone: (208) 816-8365
Street-level locationGet directions
Mailing address
2278 Moritz Ln
Indian Valley, ID 83632-5019
Registry dates
- Enumerated
- 2019-08-28
- Last updated
- 2019-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.