Healthcare Provider Details

I. General information

NPI: 1578023925
Provider Name (Legal Business Name): ZACHARY HAMNER TUTHILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15436 BEL RED RD
REDMOND WA
98052-5536
US

IV. Provider business mailing address

916 NE 65TH ST
SEATTLE WA
98115-5542
US

V. Phone/Fax

Practice location:
  • Phone: 206-267-0863
  • Fax:
Mailing address:
  • Phone: 425-274-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60509397
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: