Active NPI
Sara S Pattison, RD
- Registered Dietitian
- Tulalip, WA
National Provider Identifier
1790796597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 762187
- Practice address
- 7520 Totem Beach Rd
Tulalip, WA 98271-6160 - Phone
- (360) 651-4511
- Fax
- (360) 651-4591
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 762187 | WA | Primary |
Addresses
Primary practice location
7520 Totem Beach Rd
Tulalip, WA 98271-6160
Mailing address
7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone (360) 651-4511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7600356 | Medicaid | WA |
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 |
|---|---|---|---|
| 762187 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790796597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7520 TOTEM BEACH RD",
"city": "TULALIP",
"state": "WA",
"postal_code": "982716160",
"telephone_number": "360-651-4511",
"fax_number": "360-651-4591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7520 TOTEM BEACH RD",
"city": "TULALIP",
"state": "WA",
"postal_code": "982716160",
"telephone_number": "360-651-4511",
"fax_number": "360-651-4591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTISON",
"first_name": "SARA",
"middle_name": "S",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "762187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7600356",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulalip, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.