Provider Demographics
NPI:1104707660
Name:FUELED BY XIME LLC
Entity type:Organization
Organization Name:FUELED BY XIME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XIMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:425-449-9729
Mailing Address - Street 1:14305 271ST PL NE
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8657
Mailing Address - Country:US
Mailing Address - Phone:425-449-9729
Mailing Address - Fax:
Practice Address - Street 1:14305 271ST PL NE
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8657
Practice Address - Country:US
Practice Address - Phone:425-449-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty