Provider Demographics
NPI:1417291048
Name:TUTTLE, KADEE (MS)
Entity Type:Individual
Prefix:MRS
First Name:KADEE
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-9125
Mailing Address - Country:US
Mailing Address - Phone:253-517-1400
Mailing Address - Fax:
Practice Address - Street 1:1304 17TH AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-9125
Practice Address - Country:US
Practice Address - Phone:253-517-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA371801B174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist