Active NPI
Cheryl Crance, RD, CD
- Registered Dietitian
- Everett, WA
National Provider Identifier
1265604169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI00002030
- Practice address
- 1001 N Broadway
Suite a-3
Everett, WA 98201-1586 - Phone
- (425) 317-0300
- Fax
- (425) 317-0303
- NPI assigned
- Mar 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | DI00002030 | WA | |
| Nutritionist | 133N00000X | DI00002030 | WA | |
| Nutrition Education Nutritionist | 133NN1002X | DI00002030 | WA | |
| Registered Dietitian | 133V00000X | DI00002030 | WA | Primary |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DI00002030 | WA | |
| Renal Nutrition Registered Dietitian | 133VN1005X | DI00002030 | WA | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | DI00002030 | WA | |
| Registered Dietetic Technician | 136A00000X | DI00002030 | IL |
Addresses
Primary practice location
1001 N Broadway
Suite a-3
Everett, WA 98201-1586
Mailing address
909 N Broadway
Pbo
Everett, WA 98201-1409
Phone (425) 317-0264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DI00002030 | Other | WA | WASHINGTON STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI00002030 | WA | MD | Registered Dietitian |
| DI00002030 | IL | MD | Registered Dietetic Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services-Washington | 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.
-
dba Providence Surgery Center, Pacific Campus
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1588294854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1265604169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 N BROADWAY",
"address_2": "PBO",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011409",
"telephone_number": "425-317-0264",
"fax_number": "425-317-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N BROADWAY",
"address_2": "SUITE A-3",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011586",
"telephone_number": "425-317-0300",
"fax_number": "425-317-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANCE",
"first_name": "CHERYL",
"credential": "RD, CD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI00002030",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "WA",
"license": "DI00002030",
"primary": false
},
{
"code": "136A00000X",
"taxonomy_group": "",
"desc": "Dietetic Technician, Registered",
"state": "IL",
"license": "DI00002030",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE LICENSE",
"identifier": "DI00002030",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.