Active NPI
Charlene K. Mize, MS, RDN, CD
- Registered Dietitian
- Yakima, WA
National Provider Identifier
1497984108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI60131546
- Practice address
- 302 S 10TH Ave
Yakima, WA 98902-3521 - Phone
- (509) 249-5345
- Fax
- (509) 249-5265
- NPI assigned
- Jul 2, 2009
- Sex
- Female
- Sole proprietor
- No
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 | DI60131546 | WA | Primary |
| Registered Dietitian | 133V00000X | 984556 | WA |
Addresses
Primary practice location
302 S 10TH Ave
Yakima, WA 98902-3521
Mailing address
302 S 10TH Ave
Yakima, WA 98902-3521
Phone (509) 249-5345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2057584 | 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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 984556 | WA | MD | Registered Dietitian |
| DI60131546 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1497984108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 S 10TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023521",
"telephone_number": "509-249-5345",
"fax_number": "509-249-5265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 S 10TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023521",
"telephone_number": "509-249-5345",
"fax_number": "509-249-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZE",
"first_name": "CHARLENE",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "MS, RDN, CD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-02",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60131546",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "984556",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2057584",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.