Provider Demographics
NPI:1164637179
Name:TUTTLE, JOHN M (LMT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 894
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-0894
Mailing Address - Country:US
Mailing Address - Phone:509-548-5411
Mailing Address - Fax:509-548-0849
Practice Address - Street 1:1133 US HIGHWAY 2
Practice Address - Street 2:SUITE G
Practice Address - City:LEAVENWORTH
Practice Address - State:WA
Practice Address - Zip Code:98826-1439
Practice Address - Country:US
Practice Address - Phone:509-548-5411
Practice Address - Fax:509-548-5411
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006359172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist