MEDICARE: NUMENA NUTRITION PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1770193245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUMENA NUTRITION PLLC

Provider Business Mailing Address
First Line	:	300 LENORA ST # 1149
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	520-256-5047
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 ROOSEVELT WY NE SEATTLE
Second Line	:	STE 302, RM2
City	:	SEATTLE
State	:	WA
Zip	:	98115-2253
Country	:	US
Telephone Number	:	520-256-5047
Fax Number	:

Authorized Official
Title or Position	:	RDN, CDCES
Name	:	NEGIN EBRAHIMIFARD
Credential	:
Telephone Number	:	206-409-8119

Provider Enumeration Date	:	08/08/2020
Last Update Date	:	06/02/2026

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