Individual provider Active NPI

Andrea Likens

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1245696301
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND6656 Issued in FL
Practice address
1629 N 45TH St
Seattle, WA 98103-6701
Phone
(206) 548-5850
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 ND6656 FL Primary

Addresses

Primary practice location

1629 N 45TH St
Seattle, WA 98103-6701

Mailing address

1200 12TH Ave S Ste 901
Seattle, WA 98144-2712
Phone (206) 548-3114

Other practice location 1

350 N Clyde Morris Blvd
Suite 9
Daytona Beach, FL 32114-2733
Phone (386) 238-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718003864 WA Practitioner - Registered Dietitian Or Nutrition Professional 9931403557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborcare HealthGroup PAC ID 0143134205, 100 clinicians

Practice addresses (Care Compare)

1629 N 45TH St
Seattle, WA 98103-6701
Phone (206) 633-3350

1930 Post Aly
Seattle, WA 98101-1074
Phone (206) 728-4143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND6656FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Jun 3, 2024 Accepting new patients
Neighborcare Health CurrentSince Jun 3, 2024 Accepting new patients
Neighborcare Health Current Accepting new patients

Locations

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1245696301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-548-3114",
            "fax_number": "206-962-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036701",
            "telephone_number": "206-548-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Clyde Morris Blvd",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142733",
            "country_code": "US",
            "telephone_number": "386-238-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIKENS",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6656",
            "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 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.