Active NPI
Lois Gautam
- Registered Dietitian
- Seattle, WA
National Provider Identifier
1215419494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDD10219556
- Practice address
- 4800 Sand Point Way NE
Seattle, WA 98105-3901 - Phone
- (206) 987-2000
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | |||
| Registered Dietitian | 133V00000X | LDD10219556 | OR | Primary |
| Registered Dietitian | 133V00000X | DI60524624 | WA | |
| Registered Dietitian | 133V00000X | WA |
Addresses
Primary practice location
4800 Sand Point Way NE
Seattle, WA 98105-3901
Mailing address
10203 18TH Ave SW
Seattle, WA 98146-1315
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDD10219556 | OR | MD | Registered Dietitian |
| DI60524624 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Seattle Children'S Hospital | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Infusion Agency
- Bothell, WA
- NPI 1245383348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765756800000",
"number": "1215419494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10203 18TH AVE SW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981461315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053901",
"telephone_number": "206-987-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTAM",
"first_name": "LOIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LDD10219556",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60524624",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": null,
"primary": false
}
],
"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 Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.