JENNIFER S KIM (NPI# 1790079333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790079333 |
| Entity Type | Individual |
| Full Name | JENNIFER S KIM |
| Credential | RD, LD |
| Practice Address |
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 |
| Practice Telephone | 5034185257 |
| Mailing Telephone | 5034185257 |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
1046 | OR | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659837672 | Jennifer Kim | Physician Assistant | 18 Candy Ln, Syosset, NY 11791-4908 | 2019-02-14 |
| 1013402692 | Jennifer Park Kim | Dentist | 1671 Ih 35 E Ste 300, New Braunfels, TX 78130-6823 | 2018-06-26 |
| 1245756527 | Jennifer Kim | Behavior Technician | 7085 Tierra Roja St, El Paso, TX 79912-8492 | 2017-08-17 |
| 1205364650 | Jennifer Kim | Marriage & Family Therapist | 294 Harrington Ave Ste 6, Closter, NJ 07624-1912 | 2017-05-30 |
| 1790217115 | Jennifer Eunji Kim | Dentist | 1170 Lockhaven Way, San Jose, CA 95129-4031 | 2017-04-03 |
| 1588111645 | Jennifer Kim | Counselor | 323 N Serrano Ave Apt A, Los Angeles, CA 90004-2789 | 2016-09-07 |
| 1447614755 | Jennifer Hyun Kim | Pharmacist | 14433 Culver Dr, Irvine, CA 92604-0305 | 2016-04-12 |
| 1487035523 | Jennifer Kim | Student in an Organized Health Care Education/Training Program | 19925 22nd Ave, Whitestone, NY 11357-4121 | 2015-06-15 |
| 1255734778 | Jennifer Kim | Family Medicine | 4 E Clark Bass Blvd Ste 300, Mcalester, OK 74501-4269 | 2014-09-29 |
| 1174954879 | Jennifer Kim | Social Worker | 200 I St Se, Washington, DC 20003-3317 | 2013-12-05 |
| Street Address |
3181 SW SAM JACKSON PARK RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506301 | Jerris Robert Hedges | Emergency Medicine | 3181 Sw Sam Jackson Park Rd, # L-102, Portland, OR 97239-3011 | 2005-05-31 |
| 1114528486 | Nathan Stencel | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-11-04 |
| 1073113064 | Evan Mitchell | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-28 |
| 1629678834 | Vanessa Davie | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-27 |
| 1952901480 | Jackie Kim Sharpe | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-26 |
| 1922607530 | Leah Snyder | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-23 |
| 1932708740 | Blake Beneville | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-22 |
| 1154920833 | Isabelle Nguyen | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-22 |
| 1124627054 | Musah N Iddrisu | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-21 |
| 1386242105 | Wenelia Baghoomian | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 133VN1004X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Pediatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164832713 | Jennifer Nickell | Dietitian, Registered | 9307 Sw 51st Ave, Portland, OR 97219-5118 | 2014-05-05 |
| 1932743127 | Sarah Virginia Lowe | Dietitian, Registered | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3095 | 2019-10-31 |
| 1881244135 | Mallory Soares | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-09-18 |
| 1144705674 | Denise Crowley | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2018-10-01 |
| 1114414646 | Andrea Lyddane | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2018-04-19 |
| 1629597935 | Paige Wollenzien | Dietitian, Registered | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-09-18 |
| 1033651328 | Betty Katherine Casto Hynes | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2016-11-17 |
| 1982154043 | Mindy Smith | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2016-10-12 |
| 1841740727 | Lara Teresa Kerner | Dietitian, Registered | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2016-10-04 |
| 1720533516 | Amanda Margolin | Dietitian, Registered | 9155 Sw Barnes Rd, Suite 161, Portland, OR 97225-6625 | 2016-08-22 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.