Active NPI
Diane Margaret Wenzel, MS RDN
- Registered Dietitian
- Issaquah, WA
National Provider Identifier
1508381211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 806005
- Practice address
- 19129 SE 63Rd PL
Issaquah, WA 98027-8621 - Phone
- (970) 324-7242
- NPI assigned
- Aug 3, 2017
- Last updated
- Jul 21, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 806005 | CO | Primary |
Addresses
Primary practice location
19129 SE 63Rd PL
Issaquah, WA 98027-8621
Mailing address
19129 SE 63Rd PL
Issaquah, WA 98027-8621
Phone (970) 324-7242
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 806005 | CO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1508381211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19129 SE 63RD PL",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278621",
"telephone_number": "970-324-7242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19129 SE 63RD PL",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980278621",
"telephone_number": "970-324-7242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZEL",
"first_name": "DIANE",
"middle_name": "MARGARET",
"name_prefix": "Ms.",
"credential": "MS RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-03",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "806005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.