Evangelia Nicole Facchine, RD CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI60888449 Issued in WA

Practice address

5811 187TH Ave SE
Issaquah, WA 98027-8620

Phone

(732) 986-2633

NPI assigned

Apr 29, 2019

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dynamic Nutrition NW LLC

  • Registered Dietitian
  • Issaquah, WA
  • NPI 1780269902

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1255995973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 187TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278620",
            "telephone_number": "732-986-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 187TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278620",
            "telephone_number": "732-986-2633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 NE 128th St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980347299",
            "country_code": "US",
            "telephone_number": "425-820-0869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FACCHINE",
        "first_name": "EVANGELIA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RD CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60888449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iveta Everingham, RNFA
• Alyssa Joy Ewell, CF- SLP
• Keesha Ewers, ARNP
• Eye Institute PC
• Eye Institute, PC
• Ryan Face, DPT
• Jean Elizabeth Falls, LMHC WASHINGTON
• Kathryn K.O. Falso, PT
• Alexander Scott Fandrich, DPT, PT
• Saman Faramarzi

• Registered Dietitian in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.