Active NPI
Travis Haen, RD
- Registered Dietitian
- Spokane Valley, WA
National Provider Identifier
1366253262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86300154
- Practice address
- 14820 E 4TH Ave
Spokane Valley, WA 99216-2165 - Phone
- (509) 540-0168
- NPI assigned
- Jan 20, 2025
- Last updated
- Jan 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86300154 | ID | Primary |
Addresses
Primary practice location
14820 E 4TH Ave
Spokane Valley, WA 99216-2165
Mailing address
8618 N Boysenberry Loop
Hayden, ID 83835-5126
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86300154 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737331200000",
"number": "1366253262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8618 N BOYSENBERRY LOOP",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838355126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14820 E 4TH AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992162165",
"telephone_number": "509-540-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAEN",
"first_name": "TRAVIS",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-20",
"last_updated": "2025-01-20",
"certification_date": "2025-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "86300154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.