Provider Demographics
NPI:1376884395
Name:GUTE, MARY JUDITH (ARNP, RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JUDITH
Last Name:GUTE
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JUDITH
Other - Last Name:KUZMICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:550 17TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-320-2208
Practice Address - Fax:206-320-3362
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60768283163W00000X
WAAP60900746363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse