Individual provider Active NPI

Emily Anne Larose, RD

  • Registered Dietitian
  • Bothell, WA
National Provider Identifier
1154507358
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00002061 Issued in WA
Practice address
10808 NE 145TH St
Bothell, WA 98011-5200
Phone
(206) 296-9813
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00002061 WA Primary

Addresses

Primary practice location

10808 NE 145TH St
Bothell, WA 98011-5200

Mailing address

620 N 34TH St
Apt 608
Seattle, WA 98103-8667
Phone (415) 846-7902

Other identifiers 1

IdentifierTypeStateIssuer
927653OtherADA REGISTRATION NUMBER

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

State licenses

LicenseStateTypeSpecialty
DI00002061WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1154507358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N 34TH ST",
            "address_2": "APT 608",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038667",
            "telephone_number": "415-846-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 NE 145TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115200",
            "telephone_number": "206-296-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00002061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADA REGISTRATION NUMBER",
            "identifier": "927653",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.