Provider Demographics
NPI:1083721922
Name:HUTTON, WILLIAM STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEVEN
Last Name:HUTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BASICH BLVD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1066
Mailing Address - Country:US
Mailing Address - Phone:360-532-1950
Mailing Address - Fax:360-537-1177
Practice Address - Street 1:1100 BASICH BLVD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1066
Practice Address - Country:US
Practice Address - Phone:360-532-1950
Practice Address - Fax:360-537-1177
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025948208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE21716Medicare UPIN