Lydia Fredeen, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86036366 Issued in UT

Practice address

14508 NE 20TH Ave Ste 102
Vancouver, WA 98686-6434

Phone

(360) 852-9070

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New Leaf Nutrition Counseling, PLLC

  • Registered Dietitian
  • Seattle, WA
  • NPI 1326716325

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1750838751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434",
            "telephone_number": "360-852-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDEEN",
        "first_name": "LYDIA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "86036366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Fred Meyer Stores Inc (Fred Meyer Pharmacy #140)
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Danae Fredricksen, RN
• Linnea Fredriksson, M.D.
• Free Clinic of Southwest Washington
• Brandy M Free, LMP
• Jamie L Free

• Registered Dietitian in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.