Active NPI
Kristin Jo Davis Lesh, RD
- Registered Dietitian
- Longview, WA
National Provider Identifier
1720371354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI60209738
- Practice address
- 1615 Delaware St
Longview, WA 98632-2367 - Phone
- (360) 501-3601
- Fax
- (360) 501-3648
- NPI assigned
- May 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1042 | OR | |
| Registered Dietitian | 133V00000X | DI60209738 | WA | Primary |
Addresses
Primary practice location
1615 Delaware St
Longview, WA 98632-2367
Mailing address
1115 SE 164TH Ave
Dept. 358
Vancouver, WA 98683-9324
Phone (360) 729-1462
Other names 1
- Kristin Jo Davis
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1042 | OR | MD | Registered Dietitian |
| DI60209738 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451952000000",
"number": "1720371354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 SE 164TH AVE",
"address_2": "DEPT. 358",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839324",
"telephone_number": "360-729-1462",
"fax_number": "360-729-3104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322367",
"telephone_number": "360-501-3601",
"fax_number": "360-501-3648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS LESH",
"first_name": "KRISTIN",
"middle_name": "JO",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-16",
"last_updated": "2016-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "1042",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60209738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "DAVIS",
"middle_name": "JO",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.