Individual provider Active NPI

Mariya Shurnene, MS, RD, CN

  • Registered Dietitian
  • Monroe, WA
National Provider Identifier
1245568153
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1004001
Practice address
14701 179TH Ave SE
Monroe, WA 98272-1108
Phone
(360) 794-1447
Fax
(360) 805-3453
NPI assigned
Dec 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU 60083654 WA
Registered Dietitian 133V00000X 1004001 Primary

Addresses

Primary practice location

14701 179TH Ave SE
Monroe, WA 98272-1108

Mailing address

17807 NE 102ND CT
Redmond, WA 98052-3269
Phone (425) 895-9337

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
NU 60083654WAMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1245568153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17807 NE 102ND CT",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523269",
            "telephone_number": "425-895-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 179TH AVE SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721108",
            "telephone_number": "360-794-1447",
            "fax_number": "360-805-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURNENE",
        "first_name": "MARIYA",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU 60083654",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1004001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.