Healthcare Provider Details

I. General information

NPI: 1558102897
Provider Name (Legal Business Name): CHELA YAMARA HUTCHISON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33480 13TH PL S
FEDERAL WAY WA
98003-6357
US

IV. Provider business mailing address

8206 181ST AVE E
BONNEY LAKE WA
98391-7130
US

V. Phone/Fax

Practice location:
  • Phone: 253-285-7101
  • Fax: 253-874-7096
Mailing address:
  • Phone: 302-535-3514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number00177175
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: