Matthew Glen Koontz, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

10900 NE 4TH St Ste 2300
Bellevue, WA 98004-5882

Phone

(425) 633-2022

NPI assigned

Aug 14, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1821609678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 NE 79TH ST APT 121",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522474",
            "telephone_number": "425-633-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 NE 4TH ST STE 2300",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045882",
            "telephone_number": "425-633-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11335 NE 122nd Way Ste 105",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980346933",
            "country_code": "US",
            "telephone_number": "425-633-2022",
            "fax_number": "888-538-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 NW Leary Way Ste 400",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981075138",
            "country_code": "US",
            "telephone_number": "425-633-2022",
            "fax_number": "888-538-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 5th Ave Ste 42",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981047097",
            "country_code": "US",
            "telephone_number": "425-633-2022",
            "fax_number": "888-538-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11900 NE 1st St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980053046",
            "country_code": "US",
            "telephone_number": "425-633-2022",
            "fax_number": "888-538-8128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 5th Ave Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981011346",
            "country_code": "US",
            "telephone_number": "425-633-2022",
            "fax_number": "888-538-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "MATTHEW",
        "middle_name": "GLEN",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shabnam Koohpai
• Sheryl E. Kool, MA
• Peter Wing Fung Koon, MD
• Raymon Kooner, DC
• Kimberly Koontz, LMP
• Jonathan Chaim Kopelovich, M.D.
• Michael Koplowitz, PAC
• Kay M. Kopp, OTR
• Kor PT, LLC
• Kore Chiropractic and Rehab Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.