Lisa Ackerman, CN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

61133436 Issued in WA

Practice address

5401 Leary Ave NW Ste 202
Seattle, WA 98107-4070

Phone

(206) 297-6013

Fax

(206) 582-3472

NPI assigned

Jan 15, 2021

Last updated

May 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 16, 2023 through Mar 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Root of Medicine, PLLC

  dba Rebel Med NW

  • Naturopath
  • Seattle, WA
  • NPI 1861860090
  NPD

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1205425964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982750298",
            "telephone_number": "970-556-4409",
            "fax_number": "206-231-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 LEARY AVE NW STE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074070",
            "telephone_number": "206-297-6013",
            "fax_number": "206-582-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "LISA",
        "credential": "CN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "61133436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Achtmeyer
• Justin Achua, MD
• Michele E. Acker, ARNP
• Aubrei Ackerman, MW61419406
• Carrie Rachel Ackerman, LMP
• Stanford H. Ackley, M.D.
• Gail Acob, BSN
• Phillip Ruiz Acoba, RN
• Jessica Acolin, LMHCA
• Acorn and Oak Behavioral and Educational Services LLC

• Nutritionist in Seattle, WA
• Providers in Seattle, WA by specialty
• Nutritionist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.