Individual provider Active NPI

Jamie Kowatch, RD

  • Registered Dietitian
  • Mukilteo, WA
National Provider Identifier
1780059899
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60418927 Issued in WA
Practice address
8423 Mukilteo Speedway Ste 102
Mukilteo, WA 98275
Phone
(425) 285-5877
Fax
(425) 977-0227
NPI assigned
Dec 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 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 DI60418927 WA Primary

Addresses

Primary practice location

8423 Mukilteo Speedway Ste 102
Mukilteo, WA 98275

Mailing address

11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933
Phone (425) 285-5877

Other practice location 1

1909 214th St SE Ste 211
Bothell, WA 98021-4418
Phone (425) 791-3087

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161230000929 WA Practitioner - Registered Dietitian Or Nutrition Professional 3072894278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salute Nutrition PLLCGroup PAC ID 0345582557, 4 clinicians

Practice addresses (Care Compare)

16825 48TH Ave W
Suite 210
Lynnwood, WA 98037-6404
Phone (425) 285-5877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salute Nutrition PLLC Dietitian, Registered CurrentSince May 12, 2020 Accepting new patients

Locations

11335 NE 122nd Way
Ste 105
Kirkland, WA 98034
Phone (206) 899-5479

16825 48th Ave W
Ste 210
Lynnwood, WA 98037
Phone (425) 285-5877

8423 Mukilteo Speedway
Ste 102
Mukilteo, WA 98275
Phone (425) 285-5877

Organizations & group practices 1

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": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1780059899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND WAY STE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346933",
            "telephone_number": "425-285-5877",
            "fax_number": "425-977-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8423 MUKILTEO SPEEDWAY STE 102",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "98275",
            "telephone_number": "425-285-5877",
            "fax_number": "425-977-0227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 214th St SE Ste 211",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214418",
            "country_code": "US",
            "telephone_number": "425-791-3087",
            "fax_number": "425-791-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWATCH",
        "first_name": "JAMIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60418927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.