Marisa Kerkvliet, MSCN

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

NU60780405 Issued in WA

Practice address

617 E Laurel Rd
Bellingham, WA 98226-9728

Phone

(360) 325-5690

NPI assigned

Aug 25, 2017

Last updated

Aug 25, 2017By the provider in NPPES

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1932626496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E LAUREL RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E LAUREL RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269728",
            "telephone_number": "360-325-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERKVLIET",
        "first_name": "MARISA",
        "credential": "MSCN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU60780405",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "WA",
            "license": "NU60780405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Kenney, CPC
• Elisabeth Karen Kenoyer, R.N., CRNFA
• Jaimie Suzanne Kenoyer, PTA
• Sheryl Marie Kent, MA
• Shelly Diane Keown, RPH
• Julia Kerl, M.A.
• Sharon S Kerlin, ARNP
• Jennifer Kerr, DPT
• Ashley Ann Kerzman-Harper
• Sylvia M Ketchley, ARNP

• Nutrition Education Nutritionist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Nutrition Education Nutritionist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; 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.