Nickell, Jennifer

Nickell, Jennifer is an individual health care provider with primary practice located at 4948 Sw Meadow Ave , Lake Oswego OR 97035-2216. 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 / Nutrition, Pediatric is her primary health care specialty. Nickell, Jennifer can be contacted via phone (503) 744-2061.

Contact Information

Primary practice address
4948 Sw Meadow Ave Lake Oswego OR 97035-2216
Phone: (503) 744-2061
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X LD-D-10159758 Oregon
Dietary & Nutritional Service Providers / Nutrition, Pediatric 133VN1004X 966403

Profile Details

NPI number 1164832713
LBN Legal business name Nickell, Jennifer
Credentials MS, RD, LD
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2014
Last updated Jan 18th, 2024 - about 10 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1164832713 NPPES
Other 966403 COMMISSION ON DIETETIC REGISTRATION

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