Active NPI
Angela Marie Pham, MS, RDN, CD, LMHCA
- Nutritionist
- Seattle, WA
National Provider Identifier
1568735322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NU60275126
- Practice address
- 1429 N 45TH St
Seattle, WA 98103-6706 - Phone
- (206) 245-9543
- NPI assigned
- Feb 9, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60243915 | WA | |
| Nutritionist | 133N00000X | NU60275126 | WA | Primary |
Addresses
Primary practice location
1429 N 45TH St
Seattle, WA 98103-6706
Mailing address
1429 N 45TH St
Seattle, WA 98103-6706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 2, 2024 through Feb 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60243915 | WA | MD | Mental Health Counselor |
| NU60275126 | WA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1568735322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1429 N 45TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1429 N 45TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036706",
"telephone_number": "206-245-9543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "ANGELA",
"middle_name": "MARIE",
"credential": "MS, RDN, CD, LMHCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-09",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60243915",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "NU60275126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.