Jackie Lynn Brown, RDN

Primary specialty

Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X

License

000587 Issued in OR

Practice address

Garden Level
4805 NE Glisan St
Portland, OR 97213

Phone

(503) 215-6029

Fax

(503) 215-6387

NPI assigned

Sep 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1902528516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 SE HARVEY ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972225806",
            "telephone_number": "541-905-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GARDEN LEVEL",
            "address_2": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97213",
            "telephone_number": "503-215-6029",
            "fax_number": "503-215-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "OR",
            "license": "000587",
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "OR",
            "license": "000587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie.brown2@providence.org",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Providence Health & Services - Oregon",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business email",
            "address_1": "Garden Level",
            "address_2": "4805 NE Glisan St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Louise Brown, MA COUNSELING PSYCHO
• Heather N Brown, MD
• Idell S Brown, LPN
• Isabel Toryn Brown
• Isabella Grace Brown
• Jason Clement Brown, D.C.
• Jay P Brown, MD
• Jeffrey Josiah Brown, M.D., PH.D.
• Jeffrey Walter Brown, L.M.T.
• Jessica Brown

• 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 Sep 12, 2022; 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.