Jacquelyn Allyse Fagan, RD, CD, CEP

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI 60713040 Issued in WA

Practice address

2202 S Cedar St
Suite 300
Tacoma, WA 98405-2318

Phone

(253) 301-5280

NPI assigned

Dec 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Allyse Crews Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Dietitian, Registered

  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1891239471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST STE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-301-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "SUITE 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-301-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "JACQUELYN",
        "middle_name": "ALLYSE",
        "credential": "RD, CD, CEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI 60713040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "CREWS",
            "middle_name": "ALLYSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony Joseph Fadell, M.D.
• Holli Fadem
• Hannah Bernice Fadenrecht, DO
• Jaclyn Faestel, RN
• Paul Michael Faestel, M.D.
• Nicole Erin Fagan
• Karen Fagerstrom, RN
• Kealsye Nicola June Fahey, LMP
• Sara Jean Fahlbeck
• Jana Lynn Fahmy, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.