Active NPI
Stephen Ross Powell, RDN
- Registered Dietitian
- Everett, WA
National Provider Identifier
1386476315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI61438301
- Practice address
- 3413 30TH Dr Unit 2
Everett, WA 98201-4956 - Phone
- (573) 987-6715
- NPI assigned
- Aug 19, 2024
- 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 | DI61438301 | WA | Primary |
Addresses
Primary practice location
3413 30TH Dr Unit 2
Everett, WA 98201-4956
Mailing address
3413 30TH Dr Unit 2
Everett, WA 98201-4956
Phone (573) 987-6715
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 |
|---|---|---|---|
| DI61438301 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1386476315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3413 30TH DR UNIT 2",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014956",
"telephone_number": "573-987-6715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3413 30TH DR UNIT 2",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014956",
"telephone_number": "573-987-6715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "STEPHEN",
"middle_name": "ROSS",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI61438301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.