Fearless With Food, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

FEARLESS WITH FOOD, LLC

Practice address

2100 NE Broadway St Ste 225
Portland, OR 97232-1544

Phone

(971) 270-0590

Fax

(971) 255-1754

NPI assigned

Oct 19, 2019

Last updated

Oct 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tessa Komine, MS, RDN, LD, CDNPI 1396295580

Title

Owner

Phone

(971) 270-0590

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tessa Komine, MS, RDN, LD, CD

  • Registered Dietitian
  • Portland, OR
  • NPI 1396295580
  Authorized official Same address or phone

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

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571443200000",
    "number": "1174166441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321544",
            "telephone_number": "971-270-0590",
            "fax_number": "971-255-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321544",
            "telephone_number": "971-270-0590",
            "fax_number": "971-255-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEARLESS WITH FOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A",
        "authorized_official_last_name": "KOMINE",
        "authorized_official_first_name": "TESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-270-0590",
        "authorized_official_credential": "MS, RDN, LD, CD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500742923",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Bernadette Fazzini, PA-C
• FDS Alliance Residential LLC
• Samantha Larae Feagins
• Forrest Wayne Fearington, MD
• James Douglas Fearl, JAMES FEARL
• Bruce Wayne Feathers
• Amanda Ruth Feaver, MA
• William Jacob Fecht
• Adeline Fecker
• Clay Fedak, PSY.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2019; 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.