Active NPI
Rose Mary Brown, BS MS RD
- Registered Dietitian
- Everett, WA
National Provider Identifier
1295902609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI00001834
- Practice address
- 916 Pacific Avenue
Everett, WA 98201 - Phone
- (425) 303-6500
- Fax
- (425) 303-6550
- NPI assigned
- May 14, 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | DI00001834 | WA | |
| Registered Dietitian | 133V00000X | DI00001834 | WA | Primary |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | DI00001834 | WA | |
| Renal Nutrition Registered Dietitian | 133VN1005X | DI00001834 | WA | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | DI00001834 | WA | |
| Registered Dietetic Technician | 136A00000X | DI00001834 | WA |
Addresses
Primary practice location
916 Pacific Avenue
Everett, WA 98201
Mailing address
909 N Broadway
Pbo
Everett, WA 98201-1409
Phone (425) 317-0264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DI00001834 | Other | WA | WA ST PROFESSIONAL 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
- Credentials
- Bachelor of Science, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI00001834 | WA | MD | Dietary Manager |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1295902609",
"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": "916 PACIFIC AVENUE",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-303-6500",
"fax_number": "425-303-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "ROSE",
"middle_name": "MARY",
"credential": "BS MS RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "WA",
"license": "DI00001834",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI00001834",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "WA",
"license": "DI00001834",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "WA",
"license": "DI00001834",
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "WA",
"license": "DI00001834",
"primary": false
},
{
"code": "136A00000X",
"taxonomy_group": "",
"desc": "Dietetic Technician, Registered",
"state": "WA",
"license": "DI00001834",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA ST PROFESSIONAL LICENSE",
"identifier": "DI00001834",
"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.