Individual provider Active NPI

Jessica N Larsen, CN

  • Nutritionist
  • Vancouver, WA
National Provider Identifier
1457208571
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301
Phone
(360) 519-7631
NPI assigned
Mar 16, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X WA Primary

Addresses

Primary practice location

16703 SE McGillivray Blvd Ste 175
Vancouver, WA 98683-4301

Mailing address

16746 NW Oak Creek Dr
Beaverton, OR 97006-7481
Phone (503) 277-3509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1457208571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16746 NW OAK CREEK DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067481",
            "telephone_number": "503-277-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 SE MCGILLIVRAY BLVD STE 175",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834301",
            "telephone_number": "360-519-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "CN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.