Individual provider Active NPI

Julie Mittura, RD

  • Registered Dietitian
  • Vancouver, WA
National Provider Identifier
1346092400
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN008808 Issued in PA
Practice address
12513 NE 9TH St
Vancouver, WA 98684-5815
Phone
(267) 614-4350
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-10237107 OR
Registered Dietitian 133V00000X DN008808 PA Primary

Addresses

Primary practice location

12513 NE 9TH St
Vancouver, WA 98684-5815

Mailing address

12513 NE 9TH St
Vancouver, WA 98684-5815
Phone (267) 614-4350

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
LD-D-10237107ORMDRegistered Dietitian
DN008808PAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1346092400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12513 NE 9TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845815",
            "telephone_number": "267-614-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12513 NE 9TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845815",
            "telephone_number": "267-614-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTURA",
        "first_name": "JULIE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10237107",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN008808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.