Individual provider Active NPI

Imashi Fernando, MS, RD

  • Registered Dietitian
  • Everett, WA
National Provider Identifier
1891319513
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61079597 Issued in WA
Practice address
3901 Hoyt Ave
Everett, WA 98201-4918
Phone
(425) 339-5431
Fax
(425) 257-1423
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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 DI61079597 WA Primary

Addresses

Primary practice location

3901 Hoyt Ave
Everett, WA 98201-4918

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608002040 WA Practitioner - Registered Dietitian Or Nutrition Professional 5890195101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DI61079597WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Current Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 13, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 13, 2025 Accepting new patients
The Polyclinic CurrentSince Jan 13, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Dietitian, Registered Current Accepting new patients
Brown Sugar Nutrition PLLC Dietitian, Registered Current Accepting new patients
The Polyclinic PLLC CurrentSince Jan 13, 2025 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: imashifernando@tdh.allscriptsdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1891319513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-339-5431",
            "fax_number": "425-257-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "IMASHI",
        "credential": "MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61079597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.