Jillian Darcy Bliss, RD, LD – Registered Dietitian

Key facts

NPI: 1922481654
Entity type: Individual (NPI type 1)
Primary specialty: Registered Dietitian 133V00000X
License: LD-D-000877 (OR)
Practice address: 5211 NE Glisan St BLDG C
Portland, OR 97213
Phone: (503) 215-6628
NPI assigned: Jun 30, 2015
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Mid-Columbia Medical Center Rural Health Clinic/Center · The Dalles, OR · NPI 1154351336

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
LD-D-000877	OR	MD	Registered Dietitian

Practice roles

Organization	Specialty	Status	New patients
Mid-Columbia Medical Center		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian	133V00000X	LD-D-000877	OR	Yes

Addresses

Primary practice location

5211 NE Glisan St BLDG C
Portland, OR 97213

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers

Identifier	Type	State	Issuer
500734039	Medicaid	OR

Other providers in Portland, OR

All providers in Portland, 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 Aug 19, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.