Individual provider Active NPI

Carol Jean White, R.D.

  • Registered Dietitian
  • Renton, WA
National Provider Identifier
1710270210
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI 60209104 Issued in WA
Practice address
500 SW 39TH St
Suite 150
Renton, WA 98057-4915
Phone
(425) 264-2584
NPI assigned
May 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2011

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 DI 60209104 WA Primary

Addresses

Primary practice location

500 SW 39TH St
Suite 150
Renton, WA 98057-4915

Mailing address

15515 Juanita Woodinville Way NE
Apt C204
Bothell, WA 98011-1576
Phone (818) 445-7852

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI 60209104WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1710270210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15515 JUANITA WOODINVILLE WAY NE",
            "address_2": "APT C204",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980111576",
            "telephone_number": "818-445-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW 39TH ST",
            "address_2": "SUITE 150",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574915",
            "telephone_number": "425-264-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI 60209104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.