Individual provider Active NPI

Michael James Lynch, R,D.N, RCEP, CDE, CH

  • Registered Dietitian
  • Edmonds, WA
National Provider Identifier
1255750097
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1043196 Issued in WA
Practice address
21813 84TH Ave W Unit B
Edmonds, WA 98026-7820
Phone
(509) 481-0884
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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 1043196 WA Primary

Addresses

Primary practice location

21813 84TH Ave W Unit B
Edmonds, WA 98026-7820

Mailing address

21813 84TH Ave W Unit B
Edmonds, WA 98026-7820
Phone (509) 481-0884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180626003443 WA Practitioner - Registered Dietitian Or Nutrition Professional 4486909868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

221 4TH Ave N
Edmonds, WA 98020-3116
Phone 4258352900810884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1043196WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton CurrentSince May 9, 2018 Accepting new patients
Nutrition With Heart LLC Dietitian, Registered CurrentSince May 23, 2019 Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

221 4th Ave N
Edmonds, WA 98020
Phone (425) 697-2100

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

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.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1255750097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21813 84TH AVE W UNIT B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267820",
            "telephone_number": "509-481-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21813 84TH AVE W UNIT B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267820",
            "telephone_number": "509-481-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "R,D.N, RCEP, CDE, CH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "1043196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.