MEDICARE: MRS. ADRIENNE CLAIRE LEE RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LD-D-10251614	OR

General Provider Information

NPI Number	:	1356594865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIENNE CLAIRE LEE RDN

Provider Business Mailing Address
First Line	:	369 NE REVERE AVE STE 105
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4082
Country	:	US
Telephone Number	:	541-323-3488
Fax Number	:	541-323-3483

Provider Business Practice Location Address
First Line	:	369 NE REVERE AVE STE 105
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-4082
Country	:	US
Telephone Number	:	541-323-3488
Fax Number	:	541-323-3483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	11/26/2025

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