Provider Demographics
NPI:1801950423
Name:KUCHTYN, JULIE A (CD)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:KUCHTYN
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N JENNIFER LN
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-6013
Mailing Address - Country:US
Mailing Address - Phone:509-955-6400
Mailing Address - Fax:
Practice Address - Street 1:601 S JAMES AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5697
Practice Address - Country:US
Practice Address - Phone:509-679-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8454084Medicaid