NPIMap

Organization Active NPI

Sage Wisdom Nutrition LLC

  • Nutrition Education Nutritionist
  • Tacoma, WA
National Provider Identifier
1386029858
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
DI60417979 Issued in WA
Legal business name
SAGE WISDOM NUTRITION LLC
Practice address
1019 Pacific Ave
Suite 801
Tacoma, WA 98402-4443
Phone
(253) 254-6945
NPI assigned
Jul 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Sophia L Tasler, BSN
Title
Provider/Owner
Phone
(253) 951-4820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X DI60417979 WA Primary

Addresses

Primary practice location

1019 Pacific Ave
Suite 801
Tacoma, WA 98402-4443

Mailing address

PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911

Other identifiers 1

IdentifierTypeStateIssuer
DI60417979OtherWALICENSE NO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1386029858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-365-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE",
            "address_2": "SUITE 801",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024443",
            "telephone_number": "253-254-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE WISDOM NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "TASLER",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "253-951-4820",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "WA",
            "license": "DI60417979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "DI60417979",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.