Jessica Lynn Felly, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

10171604 Issued in OR

Practice address

7358 SW Durham Rd
Tigard, OR 97224-7307

Phone

(503) 628-9241

NPI assigned

Jun 23, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1104442409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7358 SW DURHAM RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247307",
            "telephone_number": "503-628-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7358 SW DURHAM RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247307",
            "telephone_number": "503-628-9241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4703 SE Monroe St",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972225351",
            "country_code": "US",
            "telephone_number": "262-617-2357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELLY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10171604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Brennan Feldhaus
• Sharon Ann Feldman, SLP-CCC
• Charmaine Kae Feldtman
• Jennifer Alida Felker-Norling, PSYD
• Samuel J Fellin, DO
• Brenton Thomas Felnagle
• Sarah M Felsted, MA
• Janine Fender
• Rachel C Ferguson
• Diana Christine Ferington Kelly, PWS CRM

• Registered Dietitian in Tigard, OR
• Providers in Tigard, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.