IndividualActive
Jennifer Kim, RD, LD
NPI 1790079333 · Pediatric Nutrition Registered Dietitian · Portland, OR
Provider details
- NPI number
- 1790079333
- Entity type
- Individual
- Primary specialty
- Pediatric Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD, LD
- Sex
- Female
- Sole proprietor
- No
- License
- 1046 (OR)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 418-5257
Approximate (ZIP-level) locationGet directions
Mailing address
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Registry dates
- Enumerated
- 2011-05-31
- Last updated
- 2011-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.