Active NPI
Vivienne H Dutzar, R.D.
- Registered Dietitian
- Spokane, WA
National Provider Identifier
1578783262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI00000656
- Practice address
- 101 W 8TH Ave
Spokane, WA 99204-2307 - Phone
- (509) 474-5445
- NPI assigned
- Apr 26, 2007
- 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 | DI00000656 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave
Spokane, WA 99204-2307
Mailing address
910 N Washington St Ste 209
Spokane, WA 99201-2260
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806663900 | Other | WA | IDAHO MEDICAID |
| 8354631 | Medicaid | WA | |
| GAB32999 | Other | WA | MEDICARE GROUP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI00000656 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1578783262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 N WASHINGTON ST STE 209",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992012260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-474-5445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUTZAR",
"first_name": "VIVIENNE",
"middle_name": "H",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI00000656",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO MEDICAID",
"identifier": "806663900",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8354631",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "GAB32999",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.