Provider Demographics
NPI:1134456387
Name:KUTKA, ROBYN MARIE (ND)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:MARIE
Last Name:KUTKA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SW 185TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-3081
Mailing Address - Country:US
Mailing Address - Phone:503-616-3146
Mailing Address - Fax:
Practice Address - Street 1:4700 SW 185TH AVE
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97007-3081
Practice Address - Country:US
Practice Address - Phone:503-616-3146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1709175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath