MS. MARY ELIZABETH POLHAMUS RD
NPI 1336665959
Nutritionist - Nutrition, Education in Maple Valley, WA
About Ms. Mary Elizabeth Polhamus Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MARY ELIZABETH POLHAMUS RD (NPI 1336665959) is an individual nutrition, education provider in Maple Valley, Washington, licensed in Washington (DI60752527) and active in the NPI registry since August 2017. She is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Mary Elizabeth Polhamus Rd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Mary Polhamus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Renton, WA 98055
- Reassigned Medicare billing, Washington enrollment
- 689 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MAPLE VALLEY, WA 98038
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Polhamus's NPI number?
The NPI number for Mary Polhamus is 1336665959. It was assigned to this individual provider in the NPPES registry on August 15, 2017. The provider is also known as Mary Elizabeth Walton Rd.
Where is Mary Polhamus located?
Mary Polhamus practices at 24060 SE Kent Kangley Rd Ste D100, Maple Valley, WA 98038. The listed phone number is (425) 690-3522.
What is Mary Polhamus's specialty?
The primary specialty registered for this NPI is Nutritionist, specializing in Nutrition, Education, with taxonomy code 133NN1002X.
Is Mary Polhamus enrolled in Medicare?
Yes. Mary Polhamus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mary Polhamus's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Polhamus reassigns Medicare benefits to Valley Medical Group-Renton (Renton, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Polhamus's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Polhamus accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Mary Polhamus as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Polhamus was last updated on October 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Mary Elizabeth Polhamus, RD · NPI 1336665959
Nutrition, Education provider in Maple Valley, Washington. Individual provider, active in the CMS NPPES registry since August 15, 2017.
## Identity
- **NPI:** 1336665959 (Entity type: Individual)
- **Enumerated:** August 15, 2017
- **Primary specialty:** Nutritionist - Nutrition, Education · taxonomy 133NN1002X
- **State license:** DI60752527 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 24060 SE KENT KANGLEY RD STE D100, Maple Valley, WA 98038-6851
- **Phone:** (425) 690-3522 · **Fax:** (425) 690-9522
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Valley Medical Group-Renton (NPI 1619209574, Renton, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** October 2, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1336665959) · Data from the CMS NPPES public registry.