Provider Demographics
NPI:1326183872
Name:TUTTLE, CRAIG (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 117TH PL SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4879
Mailing Address - Country:US
Mailing Address - Phone:425-308-9508
Mailing Address - Fax:
Practice Address - Street 1:616 2ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2204
Practice Address - Country:US
Practice Address - Phone:206-467-8611
Practice Address - Fax:206-467-6337
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA59443OtherLABOR & INDUSTRIES
WA8931207OtherCRIME VICTIMS
WATU4647Medicaid
WA59443OtherLABOR & INDUSTRIES