Individual provider Active NPI

Leah Dambacher, RD

  • Registered Dietitian
  • Wenatchee, WA
National Provider Identifier
1508514951
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61261002 Issued in WA
Practice address
1201 S Miller St
Wenatchee, WA 98801-3201
Phone
(509) 663-8711
NPI assigned
Mar 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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 DI61261002 WA Primary

Addresses

Primary practice location

1201 S Miller St
Wenatchee, WA 98801-3201

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/
CONNECT URL mcarssow83243@edirect.chehr.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323002691 WA Practitioner - Registered Dietitian Or Nutrition Professional 3678968963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI61261002WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dandelion Nutrition LLC Dietitian, Registered CurrentSince Sep 1, 2025 Accepting new patients
The Emily Program, PC Past Accepting new patients

Locations

4400 NE 77th Ave
Ste 275
Vancouver, WA 98662
Phone (206) 799-7010

4400 NE 77th Ave
Vancouver, WA 98662
Phone (503) 765-6335

Organizations & group practices 2

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1508514951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMBACHER",
        "first_name": "LEAH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61261002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mcarssow83243@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.