Individual
JACKIE LYNN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
GARDEN LEVEL, 4805 NE GLISAN ST, PORTLAND, OR 97213
(503) 215-6029
(503) 215-6387
Mailing address
3715 SE HARVEY ST, MILWAUKIE, OR 97222-5806
(541) 905-2567
Taxonomy
Speciality
Code
Description
License number
State
133VN1101X
Gerontological Nutrition Registered Dietitian
000587
OR
133VN1301X
Oncology Nutrition Registered Dietitian
Primary
000587
OR
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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