NPIMap

Organization Active NPI

Bravespace Nutrition LLC

Doing business as Bravespace Nutrition

  • Health Service Clinic/Center
  • Seattle, WA
National Provider Identifier
1841793973
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
604228023 Issued in WA
Legal business name
BRAVESPACE NUTRITION LLC
Doing business as
Bravespace Nutrition
Practice address
205 19TH Ave E Apt 206
Seattle, WA 98112-5355
Phone
(302) 588-2731
NPI assigned
Mar 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Authorized official

Name
Katherine Metzelaar, RDNNPI 1083114870
Title
Owner
Phone
(302) 588-2731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 604228023 WA Primary

Addresses

Primary practice location

205 19TH Ave E Apt 206
Seattle, WA 98112-5355

Mailing address

205 19TH Ave E Apt 206
Seattle, WA 98112-5355
Phone (302) 588-2731

Other names 1

  • Bravespace Nutrition Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1841793973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 19TH AVE E APT 206",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125355",
            "telephone_number": "302-588-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 19TH AVE E APT 206",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125355",
            "telephone_number": "302-588-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVESPACE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "METZELAAR",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-588-2731",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "604228023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravespace Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.