Provider Demographics
NPI:1023571957
Name:HUTTO, SHERRY ANN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:HUTTO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 121ST ST SE APT K105
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7908
Mailing Address - Country:US
Mailing Address - Phone:208-995-7093
Mailing Address - Fax:
Practice Address - Street 1:1600 121ST ST SE APT K105
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-7908
Practice Address - Country:US
Practice Address - Phone:208-995-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1608873182255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer