Active NPI
Leah Dambacher, RD
- Registered Dietitian
- Wenatchee, WA
National Provider Identifier
1508514951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI61261002
- 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
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 | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI61261002 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dandelion Nutrition LLC | Dietitian, Registered | Current | 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.
-
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- Seattle, WA
- NPI 1871948257
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.