SHANNON RAE MALLORY HERTZOG BS, MS
NPI 1124602560
Dietitian, Registered in Longview, WA
NPI Status: Active since May 11, 2021
Contact Information
1615 DELAWARE ST
LONGVIEW, WA
ZIP 98632
Phone: (360) 501-3601
Fax: (360) 501-3648
- Individual
- Female
- Dietitian, Registered
About SHANNON HERTZOG
This page provides the complete NPI Profile along with additional information for Shannon Hertzog, a provider established in Longview, Washington with a medical specialization in Dietitian, Registered. The healthcare provider is registered in the NPI registry with number 1124602560 assigned on May 2021. The practitioner's primary taxonomy code is 133V00000X with license number DI61176521 (WA). The provider is registered as an individual and her NPI record was last updated December 2025.
- NPI
- 1124602560
- Provider Name
- SHANNON RAE MALLORY HERTZOG BS, MS
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1615 DELAWARE ST LONGVIEW, WA 98632
- Location Phone
- (360) 501-3601
- Location Fax
- (360) 501-3648
- Mailing Address
- 700 NE 87TH AVE VANCOUVER, WA 98664
- Mailing Phone
- (360) 882-2778
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-11-2021
- Last Update Date
- 12-20-2025
- Code Navigator
Location Map
Secondary Locations
- 2005 W Main St Ste 130
Battle Ground, WA 98604
(360) 882-2778
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dietitian, Registered
- Taxonomy Code
- 133V00000X
- Type
- Dietary & Nutritional Service Providers
- License No.
- DI61176521
- License State
- WA
- Taxonomy Description
- A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124602560, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LONGVIEW, WA 98632
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124602560, enumerated as an "individual" on May 11, 2021.
The provider is located at 1615 DELAWARE ST LONGVIEW, WA 98632 and the phone number is (360) 501-3601.
Dietitian, Registered with taxonomy code 133V00000X.
