Individual
JESSICA NIKOLE COLLOPY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., M.S., CSR
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
11112 SW 66TH AVE, PORTLAND, OR 97223-9187
(541) 419-1444
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
19012966
OR
133VN1005X
Renal Nutrition Registered Dietitian
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Other
Enumeration date
07/26/2013
Last updated
04/25/2024
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