Individual provider Active NPI

Katelyn Marie Melara

  • Registered Dietitian
  • Vancouver, WA
National Provider Identifier
1922647890
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61513231 Issued in WA
Practice address
15815 NE 48TH Cir
Vancouver, WA 98682-5215
Phone
(360) 936-1592
NPI assigned
Dec 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Nutritionist 133N00000X NUTR.NU.61088083 WA
Registered Dietitian 133V00000X DI61513231 WA Primary

Addresses

Primary practice location

15815 NE 48TH Cir
Vancouver, WA 98682-5215

Mailing address

15815 NE 48TH Cir
Vancouver, WA 98682-5215
Phone (360) 936-1592

Other names 1

  • Katelyn Marie Boyd Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006002165 WA Practitioner - Registered Dietitian Or Nutrition Professional 4880190065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NUTR.NU.61088083WAMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 7, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 7, 2025 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 280
Vancouver, WA 98664
Phone (360) 541-2552

Organizations & group practices 4

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": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1922647890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 NE 48TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986825215",
            "telephone_number": "360-936-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15815 NE 48TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986825215",
            "telephone_number": "360-936-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELARA",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-24",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NUTR.NU.61088083",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61513231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "BOYD",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.