Jacqueline Abbott, DRPH, RDN, DOULA
Individual provider Active NPI Registered Dietitian · Oregon City, OR
NPI 1477536902 · NPPES record last updated Nov 30, 2022
Key facts
- NPI
- 1477536902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 715676 (OR)
- Practice address
- 1511 Division St Ste 102
Oregon City, OR 97045 - Phone
- (503) 698-3928
- Fax
- (503) 698-4018
- NPI assigned
- Nov 29, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Primary Care Group PC
Practice addresses (Care Compare)
12119 SE Stevens CT
Happy Valley, OR 97086-2620
Phone (503) 353-1278
3033 SE Monroe St
Milwaukie, OR 97222-6636
Phone (503) 659-4988
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170215001813 | OR | Practitioner - Registered Dietitian Or Nutrition Professional | 7810277241 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 680 | OR | MD | Registered Dietitian |
| 715676 | OR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Primary Care Group PC | Current | Accepting new patients | |
| Northwest Primary Care Group PC | Dietitian, Registered | Past | Accepting new patients |
Interoperability endpoints
- jacqueline.abbott.1@30939.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 680 | OR | |
| Doula | 374J00000X | OR | ||
| Registered Dietitian | 133V00000X | 715676 | OR | Yes |
Addresses
Primary practice location
1511 Division St Ste 102
Oregon City, OR 97045
Mailing address
2123 Sylvan Way
West Linn, OR 97068
Phone (503) 819-8571
Other providers in Oregon City, OR
- 1918 Winter Street Operating Co LLC
- 1918 Winter Street Operating Co LLC
- 24 On Physicians PC
- A Village for One
- Doris L Aasland
- Emad Abukhzam
- Access Endodontics
- Accident Care Chiropractic and Massage of Oregon City
- Adrienne Acosta
- Active Edge Physical Therapy, LLC
All providers in Oregon City, OR · Registered Dietitian in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.