Individual provider Active NPI

Stephanie Jessie Lin, RDN, CD

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1497377691
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
61000176 Issued in WA
Practice address
2319 N 45TH St Ste 103
Seattle, WA 98103-6947
Phone
(415) 322-3145
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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 61000176 WA Primary

Addresses

Primary practice location

2319 N 45TH St Ste 103
Seattle, WA 98103-6947

Mailing address

4550 38TH Ave SW Apt 537
Seattle, WA 98126-2777

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

LicenseStateTypeSpecialty
61000176WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Nutrition, LLC CurrentSince May 17, 2020 Accepting new patients

Locations

2319 N 45th St
Ste 103
Seattle, WA 98103
Phone (415) 322-3145

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": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1497377691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 38TH AVE SW APT 537",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981262777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 N 45TH ST STE 103",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036947",
            "telephone_number": "415-322-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "STEPHANIE",
        "middle_name": "JESSIE",
        "credential": "RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "61000176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.