Innovative Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

819383 Issued in WA

Legal business name

INNOVATIVE NUTRITION, LLC

Practice address

3835 Wallingford Ave N
Seattle, WA 98103-8245

Phone

(206) 719-7060

Fax

(206) 632-6632

NPI assigned

May 8, 2008

Organization subpart

No

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

Authorized official

Name

Kristin Hirano, M.S., R.D., C.N.

Title

Registered Dietitian

Phone

(206) 719-7060

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1689841702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 WALLINGFORD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 WALLINGFORD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038245",
            "telephone_number": "206-719-7060",
            "fax_number": "206-632-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "HIRANO",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "206-719-7060",
        "authorized_official_credential": "M.S., R.D., C.N."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "819383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.

Verify at the official NPI Registry.