Healthcare Provider Details

I. General information

NPI: 1689838740
Provider Name (Legal Business Name): JAMES TIMOTHY HUTTON LMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TIM HUTTON LMP

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 F ST
BELLINGHAM WA
98225-3107
US

IV. Provider business mailing address

1707 F ST
BELLINGHAM WA
98225-3107
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-1560
  • Fax:
Mailing address:
  • Phone: 360-734-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00007511
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: