Individual provider Active NPI

Mackenzie Rose Schiltz, RDN, CD

  • Registered Dietitian
  • Issaquah, WA
National Provider Identifier
1740752120
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86055578 Issued in WA
Practice address
1220 10TH Ave NE
Issaquah, WA 98029-7406
Phone
(425) 557-8900
NPI assigned
Dec 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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 86055578 WA Primary

Addresses

Primary practice location

1220 10TH Ave NE
Issaquah, WA 98029-7406

Mailing address

1711 27TH LN NE
Issaquah, WA 98029-3653
Phone (425) 890-0702

Other practice location 1

4030 Alderwood Mall Blvd
Lynnwood, WA 98036-6763
Phone (425) 776-0803

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
86055578WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1740752120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 27TH LN NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980293653",
            "telephone_number": "425-890-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 10TH AVE NE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297406",
            "telephone_number": "425-557-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Alderwood Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366763",
            "country_code": "US",
            "telephone_number": "425-776-0803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHILTZ",
        "first_name": "MACKENZIE",
        "middle_name": "ROSE",
        "credential": "RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-21",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "86055578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.