Individual provider Active NPI

Jessica Bluto, RD

  • Registered Dietitian
  • Bothell, WA
National Provider Identifier
1457761678
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1139 Issued in ME
Practice address
1909 214TH St SE Ste 211
Bothell, WA 98021
Phone
(425) 791-3087
Fax
(425) 791-3088
NPI assigned
Apr 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1139 ME Primary

Addresses

Primary practice location

1909 214TH St SE Ste 211
Bothell, WA 98021

Mailing address

1909 214TH St SE Ste 211
Bothell, WA 98021-4418
Phone (425) 791-3087

Other practice location 1

15 Rye St Ste 305
Portsmouth, NH 03801-6846
Phone (857) 304-0594

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0851NHMDAddiction (Substance Use Disorder) Counselor
221WYMDClinical Social Worker
1139MEMDEmergency Medicine Physician
1104WVMDPhysical Therapy Assistant
1710ARMDSpeech-Language Pathologist
2224KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 24, 2021 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Sep 22, 2019 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Sep 22, 2019 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 24, 2021 Accepting new patients
Life Line Community Healthcare CurrentSince Oct 10, 2017 Accepting new patients
Western Washington Medical Group, Inc PS Current Accepting new patients

Locations

400 W Capitol Ave
Ste 1700
Little Rock, AR 72201
Phone (501) 238-3509

309 Court Ave
Ste 200
Des Moines, IA 50309
Phone (507) 848-5140

1340 Poydras St
Ste 2000
New Orleans, LA 70112

625 Kenmoor Ave SE
Ste 301
Grand Rapids, MI 49546
Phone (231) 519-8300

3970 Post Rd
Warwick, RI 02886
Phone (216) 377-4179

1909 214th St SE
Ste 211
Bothell, WA 98021
Phone (425) 248-2626

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

4404 80th St NE
Marysville, WA 98270
Phone (360) 659-1231

Organizations & group practices 6

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1457761678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 211",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214418",
            "telephone_number": "425-791-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 211",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98021",
            "telephone_number": "425-791-3087",
            "fax_number": "425-791-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Rye St Ste 305",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038016846",
            "country_code": "US",
            "telephone_number": "857-304-0594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUTO",
        "first_name": "JESSICA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "1139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.