MEDICARE: STACEY ANN MCCUTCHEON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP.AP.70091351-NP	WA

General Provider Information

NPI Number	:	1518817683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY ANN MCCUTCHEON ARNP

Provider Business Mailing Address
First Line	:	617 EASTLAKE AVE E STE 410
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-5681
Country	:	US
Telephone Number	:	206-312-5373
Fax Number	:	206-259-2457

Provider Business Practice Location Address
First Line	:	34509 9TH AVE S STE 104
Second Line	:
City	:	FEDERAL WAY
State	:	WA
Zip	:	98003-8707
Country	:	US
Telephone Number	:	206-312-5373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	03/10/2026

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