Individual provider Active NPI

Breanne McIntyre, RDN

  • Registered Dietitian
  • Moses Lake, WA
National Provider Identifier
1366041188
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DIET.DI.61117917 Issued in WA
Practice address
2000 S Clover Dr
Moses Lake, WA 98837-4417
Phone
(509) 793-9605
Fax
(509) 764-3203
NPI assigned
Oct 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DIET.DI.61117917 WA Primary

Addresses

Primary practice location

2000 S Clover Dr
Moses Lake, WA 98837-4417

Mailing address

1616 S Pioneer Way
Moses Lake, WA 98837-2487
Phone (509) 793-9715

Other identifiers 1

IdentifierTypeStateIssuer
2173383MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223000483 WA Practitioner - Registered Dietitian Or Nutrition Professional 8729490339 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI61117917WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Grant County Public Hospital District 1 Current Accepting new patients
Wenatchee Valley Hospital CurrentSince Dec 11, 2020 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Oct 28, 2024 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Oct 28, 2024 Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

2000 S Clover Dr
Moses Lake, WA 98837
Phone (509) 765-5606

1616 S Pioneer Way
Moses Lake, WA 98837

840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400

660 S Coolidge St
Moses Lake, WA 98837

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Organizations & group practices 6

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": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1366041188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372487",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S CLOVER DR",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374417",
            "telephone_number": "509-793-9605",
            "fax_number": "509-764-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "BREANNE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DIET.DI.61117917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2173383",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.