Healthcare Provider Details

I. General information

NPI: 1801950423
Provider Name (Legal Business Name): JULIE A KUCHTYN C.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S JAMES AVE
EAST WENATCHEE WA
98802-5697
US

IV. Provider business mailing address

705 N JENNIFER LN
EAST WENATCHEE WA
98802-6013
US

V. Phone/Fax

Practice location:
  • Phone: 509-679-3128
  • Fax:
Mailing address:
  • Phone: 509-955-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI00001774
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: