Amanda Frances Ellis, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

915 118TH Ave SE, Attention Alecia Johnson, Ret Physica
Suite 110
Bellevue, WA 98005

Phone

(425) 243-6922

Fax

(425) 452-0704

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1386138907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 118TH AVE SE, ATTENTION ALECIA JOHNSON, RET PHYSICA",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-243-6922",
            "fax_number": "425-452-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 118TH AVE SE, ATTENTION ALECIA JOHNSON, RET PHYSICA",
            "address_2": "SUITE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-243-6922",
            "fax_number": "425-452-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AMANDA",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mouna Elkhadiri, PSY.D.
• Anna Elkin
• Don Elle, LMFT CDP
• Brian Charles Ellez, LMHC
• Mackenzie Ellington, SLP
• Christie Ellis, LMP
• Erin Janine Ellis
• Giovanina Ellis, SLP
• Cassandra Joan Ellsworth, LMFT
• Dustin Luke Ellzey, PT, DPT

• Registered Dietitian in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.