Active NPI
Jaime Joann Waliczek, MS, RD, CD
- Registered Dietitian
- Seattle, WA
National Provider Identifier
1104147750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI60149382
- Practice address
- 4241 11TH Ave NE Ste B
Seattle, WA 98105-4674 - Phone
- (425) 445-0921
- Fax
- (206) 774-6045
- NPI assigned
- Jun 17, 2010
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI60149382 | WA | Primary |
Addresses
Primary practice location
4241 11TH Ave NE Ste B
Seattle, WA 98105-4674
Mailing address
4241 11TH Ave NE Ste B
Seattle, WA 98105-4674
Phone (425) 445-0921
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI60149382 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276732800000",
"number": "1104147750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4241 11TH AVE NE STE B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054674",
"telephone_number": "425-445-0921",
"fax_number": "206-774-6045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4241 11TH AVE NE STE B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054674",
"telephone_number": "425-445-0921",
"fax_number": "206-774-6045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALICZEK",
"first_name": "JAIME",
"middle_name": "JOANN",
"credential": "MS, RD, CD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-17",
"last_updated": "2010-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60149382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.