1033371505 NPI number — KATHLEEN ERIN HUTCHINSON PT DPT

Table of content: KATHLEEN ERIN HUTCHINSON PT DPT (NPI 1033371505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033371505 NPI number — KATHLEEN ERIN HUTCHINSON PT DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUTCHINSON
Provider First Name:
KATHLEEN
Provider Middle Name:
ERIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT DPT
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:
1033371505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5050 STATE HIGHWAY 303 NE # 103-221
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREMERTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98311-3629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-474-3274
Provider Business Mailing Address Fax Number:
360-824-6720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1550 NE RIDDELL RD STE 170
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREMERTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98310-3060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-474-3274
Provider Business Practice Location Address Fax Number:
360-824-6720
Provider Enumeration Date:
06/26/2008

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: 225100000X , with the licence number:  PT60028941 , 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)





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