Individual provider Active NPI

Evelina Miropolsky, MS, RD, CD

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1609462076
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86154805 Issued in WA
Practice address
1200 5TH Ave Ste 800
Seattle, WA 98101-3136
Phone
(206) 374-0109
NPI assigned
Dec 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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 86154805 WA Primary

Addresses

Primary practice location

1200 5TH Ave Ste 800
Seattle, WA 98101-3136

Mailing address

1200 5TH Ave Ste 800
Seattle, WA 98101-3136
Phone (206) 374-0109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 6, 2021 through Jan 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86154805WAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1609462076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013136",
            "telephone_number": "206-374-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE STE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013136",
            "telephone_number": "206-374-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROPOLSKY",
        "first_name": "EVELINA",
        "credential": "MS, RD, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "86154805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.