Active NPI
Bernita R Lacroix, R. D.
- Registered Dietitian
- Olympia, WA
National Provider Identifier
1982848024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI 00000907
- Practice address
- 4820 She Nah Num Dr SE
Olympia, WA 98513-9105 - Phone
- (360) 459-5312
- NPI assigned
- Apr 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI 00000907 | WA | Primary |
Addresses
Primary practice location
4820 She Nah Num Dr SE
Olympia, WA 98513-9105
Mailing address
3314 Serenity LN SW
Tumwater, WA 98512-1102
Phone (360) 493-1884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI 00000907 | WA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240185600000",
"number": "1982848024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3314 SERENITY LN SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985121102",
"telephone_number": "360-493-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 SHE NAH NUM DR SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985139105",
"telephone_number": "360-459-5312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACROIX",
"first_name": "BERNITA",
"middle_name": "R",
"credential": "R. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-20",
"last_updated": "2009-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI 00000907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.