Active NPI
Amanda Wood
- Registered Dietitian
- Bellevue, WA
National Provider Identifier
1558790238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI60420810
- Practice address
- 4455 148TH Ave NE
Bellevue, WA 98007-3120 - Phone
- (425) 861-6258
- Fax
- (425) 869-5285
- NPI assigned
- Nov 4, 2013
- Last updated
- Nov 4, 2013
- 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 | DI60420810 | WA | Primary |
Addresses
Primary practice location
4455 148TH Ave NE
Bellevue, WA 98007-3120
Mailing address
4455 148TH Ave NE
Bellevue, WA 98007-3120
Phone (425) 861-6258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2015 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI60420810 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1558790238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4455 148TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073120",
"telephone_number": "425-861-6258",
"fax_number": "425-869-5285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 148TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073120",
"telephone_number": "425-861-6258",
"fax_number": "425-869-5285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-04",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60420810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.