Individual provider Active NPI

Jennifer T Okemah, MS, RD, CD, BC-ADM

  • Registered Dietitian
  • Kirkland, WA
National Provider Identifier
1669488581
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00001847 Issued in WA
Practice address
11335 NE 122ND Way Ste 105205
Kirkland, WA 98034
Phone
(425) 285-5877
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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 DI00001847 WA Primary

Addresses

Primary practice location

11335 NE 122ND Way Ste 105205
Kirkland, WA 98034

Mailing address

9727 NE Juanita Dr Apt 205
Kirkland, WA 98034-4259
Phone (425) 299-8774

Other practice location 1

14701 179th Ave SE
Monroe, WA 98272-1108
Phone (360) 794-1447 ext. 370

Other practice location 2

9727 NE Juanita Dr Apt 205
Kirkland, WA 98034
Phone (425) 299-8774

Other identifiers 2

IdentifierTypeStateIssuer
8457848MedicaidWA
DI00001847OtherWALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061011000011 WA Practitioner - Registered Dietitian Or Nutrition Professional 1557367034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salute Nutrition PLLCGroup PAC ID 0345582557, 4 clinicians

Practice addresses (Care Compare)

16825 48TH Ave W
Suite 210
Lynnwood, WA 98037-6404
Phone (425) 285-5877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Salute Nutrition PLLC Dietitian, Registered CurrentSince Feb 25, 2019 Accepting new patients

Locations

11335 NE 122nd Way
Ste 105
Kirkland, WA 98034
Phone (206) 899-5479

16825 48th Ave W
Ste 210
Lynnwood, WA 98037
Phone (425) 285-5877

707 S Grady Way
Ste 600
Renton, WA 98057
Phone (206) 257-2987

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1669488581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9727 NE JUANITA DR APT 205",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344259",
            "telephone_number": "425-299-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND WAY STE 105205",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-285-5877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14701 179th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982721108",
            "country_code": "US",
            "telephone_number": "360-794-1447 x370",
            "fax_number": "360-805-3453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9727 NE Juanita Dr Apt 205",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "98034",
            "country_code": "US",
            "telephone_number": "425-299-8774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKEMAH",
        "first_name": "JENNIFER",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CD, BC-ADM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8457848",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DI00001847",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.