NPIMap

Organization Active NPI

Nutrition Authority

  • Registered Dietitian
  • Puyallup, WA
National Provider Identifier
1043671043
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
60610914 Issued in WA
Legal business name
NUTRITION AUTHORITY
Practice address
3712 9TH St SW
Suite 1a
Puyallup, WA 98373-3564
Phone
(855) 328-4543
NPI assigned
Mar 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brooke Douglas, RDNNPI 1730387986
Title
Ceo
Phone
(855) 328-4543

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 60610914 WA Primary

Addresses

Primary practice location

3712 9TH St SW
Suite 1a
Puyallup, WA 98373-3564

Mailing address

3712 9TH St SW
Suite 1a
Puyallup, WA 98373-3564

National Provider Directory

National Provider Directory
Tax ID family
Nutrition Authority PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1043671043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 9TH ST SW",
            "address_2": "SUITE 1A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 9TH ST SW",
            "address_2": "SUITE 1A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733564",
            "telephone_number": "855-328-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-328-4543",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "60610914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.