Individual provider Active NPI

Nila Norine Williamson, MPH, RD, CD, IBCLC

  • Pediatric Nutrition Registered Dietitian
  • Olympia, WA
National Provider Identifier
1265752018
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
DI 60043903 Issued in WA
Practice address
3434 12TH Ave NE
Olympia, WA 98506-5175
Phone
(360) 413-8470
Fax
(360) 419-5660
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-15637
Pediatric Nutrition Registered Dietitian 133VN1004X DI 60043903 WA Primary

Addresses

Primary practice location

3434 12TH Ave NE
Olympia, WA 98506-5175

Mailing address

323 Maple Park Ave SE
Olympia, WA 98501-2360
Phone (360) 449-6791

Other practice location 1

120 State Ave NE # 265
Olympia, WA 98501-1131
Phone (360) 499-6791

Other names 1

  • Nila Norine Gregory Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI 60043903WAMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nila Williamson Nutrition PLLC Nutrition, Pediatric CurrentSince Jan 26, 2025 Accepting new patients
Westbound Speech Therapy PLLC Past Accepting new patients

Locations

120 State Ave NE
Olympia, WA 98501
Phone (360) 352-5581

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1265752018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MAPLE PARK AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012360",
            "telephone_number": "360-449-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065175",
            "telephone_number": "360-413-8470",
            "fax_number": "360-419-5660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 State Ave NE # 265",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985011131",
            "country_code": "US",
            "telephone_number": "360-499-6791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "NILA",
        "middle_name": "NORINE",
        "credential": "MPH, RD, CD, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-15637",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "WA",
            "license": "DI 60043903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NILA",
            "last_name": "GREGORY",
            "middle_name": "NORINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.