1568527349 NPI number — MRS. JANETTE R HUTCHISON BC-HIS

Table of content: MRS. JANETTE R HUTCHISON BC-HIS (NPI 1568527349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568527349 NPI number — MRS. JANETTE R HUTCHISON BC-HIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUTCHISON
Provider First Name:
JANETTE
Provider Middle Name:
R
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BC-HIS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568527349
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1933 RIVERSIDE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOQUIAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98550-2742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-533-2778
Provider Business Mailing Address Fax Number:
360-533-4169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1933 RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOQUIAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98550-2742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-533-2778
Provider Business Practice Location Address Fax Number:
360-533-4169
Provider Enumeration Date:
12/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  HA00002414 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0213492 . This is a "STATE L&I PROV. NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9058959 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".