Jessica Marie Verbrugge, RD, LMT

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86088742 Issued in WA

Practice address

7533 Canyon View Drive
Deming, WA 98244

Phone

(360) 739-7062

NPI assigned

Jan 12, 2015

Last updated

May 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Jessica Marie Wilburn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589673600000",
    "number": "1659760965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1780",
            "city": "MAPLE FALLS",
            "state": "WA",
            "postal_code": "982661780",
            "telephone_number": "360-739-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7533 CANYON VIEW DRIVE",
            "city": "DEMING",
            "state": "WA",
            "postal_code": "98244",
            "telephone_number": "360-739-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBRUGGE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RD, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "86088742",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60401354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WILBURN",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Deming, WA
• Providers in Deming, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.