Provider Demographics
NPI:1144932401
Name:BREZSNY-FELDMAN, JASPER (RDN)
Entity type:Individual
Prefix:
First Name:JASPER
Middle Name:
Last Name:BREZSNY-FELDMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 NW QUIMBY ST APT 525
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2380
Mailing Address - Country:US
Mailing Address - Phone:541-517-8635
Mailing Address - Fax:
Practice Address - Street 1:2112 NW QUIMBY ST APT 525
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2380
Practice Address - Country:US
Practice Address - Phone:541-517-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered