Active NPI
Nataly Ella Nislow, CNS
- Nutritionist
- Kirkland, WA
National Provider Identifier
1265024640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 61104713
- Practice address
- 13813 88TH Ave NE
Kirkland, WA 98034-1769 - Phone
- (410) 236-5832
- NPI assigned
- Feb 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 61104713 | WA | Primary |
Addresses
Primary practice location
13813 88TH Ave NE
Kirkland, WA 98034-1769
Mailing address
13813 88TH Ave NE
Kirkland, WA 98034-1769
Phone (410) 236-5832
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 7, 2022 through May 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61104713 | WA | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simplicity Nutrition, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Registered Dietitian
- North Bend, WA
- NPI 1366981292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1265024640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13813 88TH AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980341769",
"telephone_number": "410-236-5832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13813 88TH AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980341769",
"telephone_number": "410-236-5832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISLOW",
"first_name": "NATALY",
"middle_name": "ELLA",
"name_prefix": "Mrs.",
"credential": "CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "61104713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.