Active NPI
Joanne Usdavin
- Nutritionist
- Bellevue, WA
National Provider Identifier
1326435884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NU 60242284
- Practice address
- 1750 112TH Ave NE BLDG 4
Bellevue, WA 98004-3752 - Phone
- (425) 289-0381
- NPI assigned
- Apr 22, 2015
- 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 | NU 60242284 | WA | Primary |
Addresses
Primary practice location
1750 112TH Ave NE BLDG 4
Bellevue, WA 98004-3752
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
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 |
|---|---|---|---|
| NU 60242284 | WA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495584000000",
"number": "1326435884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 112TH AVE NE BLDG 4",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043752",
"telephone_number": "425-289-0381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "USDAVIN",
"first_name": "JOANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-22",
"last_updated": "2017-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "NU 60242284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.