Active NPI
Susan Jane Yake, RD CD CDE CLC
- Registered Dietitian
- Bremerton, WA
National Provider Identifier
1407826548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 427023
- Practice address
- 1 Boone Rd
Bremerton, WA 98312-1894 - Phone
- (360) 475-4426
- Fax
- (360) 475-4344
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 427023 | WA | Primary |
| Registered Dietitian | 133V00000X | 00000055 | WA |
Addresses
Primary practice location
1 Boone Rd
Bremerton, WA 98312-1894
Mailing address
1 Boone Rd
Bremerton, WA 98312-1894
Phone (360) 475-4426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8388340 | Medicaid | WA |
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 |
|---|---|---|---|
| 427023 | WA | MD | Registered Dietitian |
| 00000055 | WA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1407826548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BOONE RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121894",
"telephone_number": "360-475-4426",
"fax_number": "360-475-4344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BOONE RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121894",
"telephone_number": "360-475-4426",
"fax_number": "360-475-4344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAKE",
"first_name": "SUSAN",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "RD CD CDE CLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "427023",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "00000055",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8388340",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.