Provider Demographics
NPI:1881019982
Name:FRIZZELL HUTCHINSON, KAELA (DO)
Entity Type:Individual
Prefix:
First Name:KAELA
Middle Name:
Last Name:FRIZZELL HUTCHINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAELA
Other - Middle Name:
Other - Last Name:FRIZZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 SE PARK PLAZA DR STE 140
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5887
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:360-449-7040
Practice Address - Street 1:203 SE PARK PLAZA DR STE 140
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5887
Practice Address - Country:US
Practice Address - Phone:360-449-7042
Practice Address - Fax:360-449-7040
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
WAOP61054207207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No174400000XOther Service ProvidersSpecialist