Provider Demographics
NPI:1841364627
Name:CAREY, RUTH (RD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:CAREY
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 1:15851 NE EILERS RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OR
Mailing Address - Zip Code:97002-8508
Mailing Address - Country:US
Mailing Address - Phone:503-648-2425
Mailing Address - Fax:
Practice Address - Street 1:19875 SW 65TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8353
Practice Address - Country:US
Practice Address - Phone:503-708-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR124133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered