MS. MARY ELIZABETH POLHAMUS (RD) – Nutrition Education Nutritionist, NPI 1336665959
Nutrition Education Nutritionist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
284 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in WA
Provider Addresses for MS. MARY ELIZABETH POLHAMUS (RD)
24060 SE KENT KANGLEY RD STE D100
MAPLE VALLEY, WA 980386851
Phone: (425) 690-3522
Fax: (425) 690-9522
Type: Location
Talbot Professional Center, 4011, Talbot Road South, Talbot Hill, Renton, King County, Washington, 98055, United States
RENTON, WA 980555773
Phone: (425) 656-4006
Fax: (425) 656-4265
Type: Location
PO BOX 34876
SEATTLE, WA 981241876
Phone: (425) 690-2715
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-04-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180426002077 | I | Registered Dietitian Or Nutrition Professional | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98038)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | WA | |
| Physical Therapist In Private Practice | WA | |
| Internal Medicine, Hospitalist | WA | |
| P S Y C H I A T R Y | WA | |
| Hospice/Palliative Care, Internal Medicine | WA | |
| Internal Medicine, Hospitalist | CA | |
| Family Practice | WA | |
| Family Practice, Emergency Medicine | WA | |
| - | WA | |
| - | WA |
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