Active NPI
Andrea Vanderwoude
- Sports Dietetics Nutrition Registered Dietitian
- Renton, WA
National Provider Identifier
1023936432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Dietetics Nutrition Registered Dietitian
- License
- 86009751
- Practice address
- 12 Seahawks Way
Renton, WA 98056-1572 - Phone
- (208) 249-9590
- NPI assigned
- Jul 6, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X | 86009751 | WA | Primary |
Addresses
Primary practice location
12 Seahawks Way
Renton, WA 98056-1572
Mailing address
12 Seahawks Way
Renton, WA 98056-1572
Phone (208) 249-9590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1023936432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 SEAHAWKS WAY",
"city": "RENTON",
"state": "WA",
"postal_code": "980561572",
"telephone_number": "208-249-9590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 SEAHAWKS WAY",
"city": "RENTON",
"state": "WA",
"postal_code": "980561572",
"telephone_number": "208-249-9590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERWOUDE",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-06",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": "WA",
"license": "86009751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.