Provider Demographics
NPI:1184013393
Name:HUTCHISON, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 E MILL PLAIN BLVD
Mailing Address - Street 2:APT. 81
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2569
Mailing Address - Country:US
Mailing Address - Phone:360-953-8919
Mailing Address - Fax:
Practice Address - Street 1:8701 E MILL PLAIN BLVD
Practice Address - Street 2:APT. 81
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2569
Practice Address - Country:US
Practice Address - Phone:360-953-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003379101YA0400X
WALH00007995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)