Individual provider Active NPI

Katelyn Justice, RDN

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1710641444
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1023006 Issued in WA
Practice address
1145 Broadway
Seattle, WA 98122-4201
Phone
(206) 329-1760
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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 1023006 WA Primary

Addresses

Primary practice location

1145 Broadway
Seattle, WA 98122-4201

Mailing address

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

Other practice location 1

35 Miller Ave Ste 273
Mill Valley, CA 94941-1903
Phone (415) 302-3651

Other names 1

  • Katelyn Murray Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605002847 WA Practitioner - Registered Dietitian Or Nutrition Professional 6608318696 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023006WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Apr 14, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince May 1, 2024 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 14, 2025 Accepting new patients
The Polyclinic CurrentSince May 1, 2024 Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

1200 112th Ave NE
Ste C160
Bellevue, WA 98004
Phone (425) 453-1039

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

125 130th St SE
Everett, WA 98208
Phone (425) 341-4800

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1710641444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-329-1760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Miller Ave Ste 273",
            "address_purpose": "LOCATION",
            "city": "Mill Valley",
            "state": "CA",
            "postal_code": "949411903",
            "country_code": "US",
            "telephone_number": "415-302-3651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "KATELYN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "1023006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "MURRAY",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.