Healthcare Provider Details

I. General information

NPI: 1740589001
Provider Name (Legal Business Name): GARRY HUFSTETLER PBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14729 317TH ST NE
ARLINGTON WA
98223-9396
US

IV. Provider business mailing address

PO BOX 594
ARLINGTON WA
98223-0501
US

V. Phone/Fax

Practice location:
  • Phone: 425-350-0492
  • Fax:
Mailing address:
  • Phone: 425-350-0492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: