MIRIAM SARA BALLEJOS (NPI# 1336484864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336484864 |
| Entity Type | Individual |
| Full Name | MIRIAM SARA BALLEJOS |
| Other Name | MIRIAM SARA EDLEFSEN |
| Credential | PHD, RD |
| Practice Address |
9040a Jackson Ave Tacoma WA 98431 |
| Mailing Address |
9040a Jackson Ave Tacoma WA 98431-0001 |
| Practice Telephone | 2539680547 |
| Mailing Telephone | 2539680547 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2020-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DI60224467 | WA | Dietary & Nutritional Service Providers |
| Street Address |
9040A JACKSON AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013905249 | Richard Lyle Urbon Jr. | Internal Medicine | 9040a Jackson Ave, Tacoma, WA 98431-6283 | 2005-10-11 |
| 1962003111 | Zachary Tegen | Spec/Tech, Cardiovascular | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2020-11-04 |
| 1225681968 | Elena Brooke Haymond | Social Worker | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2019-07-22 |
| 1326529116 | Molly Glockling | Nurse Practitioner | 9040a Jackson Ave, Tacoma, WA 98431-1130 | 2018-08-28 |
| 1972009108 | Joshua Davey Read | Student in an Organized Health Care Education/Training Program | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2018-04-05 |
| 1114434701 | Timothy Edward Hausmann | Nurse Anesthetist, Certified Registered | 9040a Jackson Ave, Tacoma, WA 98431-5656 | 2018-01-04 |
| 1003350687 | Madigan Army Medical Center | Military Hospital | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2016-12-15 |
| 1649624453 | Madigan Army Medical Center | General Acute Care Hospital | 9040a Jackson Ave, Att: Mchj-c-e, Tacoma, WA 98431-0001 | 2016-04-18 |
| 1962866921 | Christina Renee Yoon | Registered Nurse | 9040a Jackson Ave, Attn: Mchj-clq-q, Christina Yoon Rn, Tacoma, WA 98431-1100 | 2016-04-06 |
| 1174996292 | Sara Whitney Young | Dietitian, Registered | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2015-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518586007 | Paige Worley | Dietitian, Registered | 3905 N 36th St, Tacoma, WA 98407-5634 | 2020-04-14 |
| 1659933554 | Julia Budniak | Dietitian, Registered | 9040 Jackson Street, Tacoma, WA 98431-0001 | 2019-07-01 |
| 1740755636 | Erika Mary Clough | Dietitian, Registered | 3401 S 19th St Ste 100, Tacoma, WA 98405-1909 | 2018-10-08 |
| 1417422577 | Paul Holthaus | Dietitian, Registered | 9040 Jackson Ave Nutrition Clinic, Tacoma, WA 98431-0001 | 2018-10-04 |
| 1003320078 | Christina Stapke | Dietitian, Registered | 1624 South I St. Ste 205, Tacoma, WA 98405 | 2017-11-28 |
| 1023530227 | Alexandra Alyse Mckee | Dietitian, Registered | 233 St Helens Ave Apt 403, Tacoma, WA 98402-2585 | 2017-07-10 |
| 1407386287 | Amber E Lagerwey | Dietitian, Registered | 15703 Pacific Ave S Ste B, Tacoma, WA 98444-4675 | 2017-06-14 |
| 1578011425 | Kyleigh Harlow | Dietitian, Registered | 11011 Park Ave S, C212, Tacoma, WA 98444 | 2016-09-20 |
| 1528439718 | Hannah Lima | Dietitian, Registered | 12615 26th Ave E, Tacoma, WA 98445-5014 | 2015-10-13 |
| 1871907519 | Anne B Corley | Dietitian, Registered | 2102 N Pearl St Ste 405, Tacoma, WA 98406-2550 | 2014-06-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.