MEDICARE: ASHLEY KLEES NUTRITION LLC

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

General Provider Information

NPI Number	:	1912833591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY KLEES NUTRITION LLC

Provider Business Mailing Address
First Line	:	2705 E BURNSIDE ST STE 206
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1768
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2705 E BURNSIDE ST STE 206
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1768
Country	:	US
Telephone Number	:	971-360-9940
Fax Number	:

Authorized Official
Title or Position	:	OWNER, MANAGING MEMBER
Name	:	ASHLEY KLEES
Credential	:	RD, LD, CDCES
Telephone Number	:	971-360-9940

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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