Provider Demographics
NPI:1184906018
Name:SHUTE, SUMMER LYNN
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:LYNN
Last Name:SHUTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4478 162ND CT SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-9002
Mailing Address - Country:US
Mailing Address - Phone:425-269-6945
Mailing Address - Fax:
Practice Address - Street 1:4478 162ND CT SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-9002
Practice Address - Country:US
Practice Address - Phone:425-269-6945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula