Healthcare Provider Details

I. General information

NPI: 1396249132
Provider Name (Legal Business Name): SARAH STREETER HUTCHESON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 HOYT AVE
EVERETT WA
98201-4988
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5450
  • Fax: 425-259-1151
Mailing address:
  • Phone: 425-304-8431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61146458
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: