Individual provider Active NPI

Irene F Marble, RD, CDE

  • Registered Dietitian
  • Port Townsend, WA
National Provider Identifier
1821287665
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00000218 Issued in WA
Practice address
834 Sheridan Ave
Port Townsend, WA 98368
Phone
(360) 385-2200
Fax
(360) 379-4381
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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 DI00000218 WA Primary

Addresses

Primary practice location

834 Sheridan Ave
Port Townsend, WA 98368

Mailing address

834 Sheridan Ave
Port Townsend, WA 98368
Phone (360) 385-2200

Other identifiers 1

IdentifierTypeStateIssuer
8274581MedicaidWA

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
DI00000218WAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1821287665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN AVE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-2200",
            "fax_number": "360-379-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN AVE",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-2200",
            "fax_number": "360-379-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "IRENE",
        "middle_name": "F",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00000218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8274581",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.