Provider Demographics
NPI:1508261595
Name:ROBYN KUTKA ND, LLC
Entity Type:Organization
Organization Name:ROBYN KUTKA ND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUTKA
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-869-9249
Mailing Address - Street 1:9125 SW DAVIES RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-6788
Mailing Address - Country:US
Mailing Address - Phone:503-869-9249
Mailing Address - Fax:
Practice Address - Street 1:14250 SW BARROWS RD
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-2049
Practice Address - Country:US
Practice Address - Phone:503-406-8748
Practice Address - Fax:888-977-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1709175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty