Devore, Jacque

Devore, Jacque is an sole proprietor health care provider with primary practice located at 6725 Se 19Th Ave , Portland OR 97202-5635. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Dietary & Nutritional Service Providers / Nutrition, Pediatric. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Devore, Jacque can be contacted via phone (503) 753-4561.

Contact Information

Primary practice address
6725 Se 19Th Ave Portland OR 97202-5635
Phone: (503) 753-4561
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X LD D 10151892 Oregon
Dietary & Nutritional Service Providers / Nutrition, Pediatric 133VN1004X LD D 10151892 Oregon

Profile Details

NPI number 1740652692
LBN Legal business name Devore, Jacque
Credentials RD, MPH, LD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 29th, 2015
Last updated Oct 29th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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