Provider Demographics
NPI:1477515526
Name:HUTCHASON, DAVID MICHARL (ARNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHARL
Last Name:HUTCHASON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 BEACH DRIVE EAST
Mailing Address - Street 2:
Mailing Address - City:RETSIL
Mailing Address - State:WA
Mailing Address - Zip Code:98378
Mailing Address - Country:US
Mailing Address - Phone:360-895-4710
Mailing Address - Fax:
Practice Address - Street 1:1141 BEACH DRIVE EAST
Practice Address - Street 2:
Practice Address - City:RETSIL
Practice Address - State:WA
Practice Address - Zip Code:98378
Practice Address - Country:US
Practice Address - Phone:360-895-4710
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004263363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9619958Medicaid
WAS45874Medicare UPIN
WA9619958Medicaid