Healthcare Provider Details

I. General information

NPI: 1518817683
Provider Name (Legal Business Name): STACEY ANN MCCUTCHEON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 NE 1ST ST STE 3023
BELLEVUE WA
98005-3046
US

IV. Provider business mailing address

11900 NE 1ST ST STE 3023
BELLEVUE WA
98005-3046
US

V. Phone/Fax

Practice location:
  • Phone: 425-600-5227
  • Fax:
Mailing address:
  • Phone: 425-600-5227
  • Fax: 509-447-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70091351-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: