Healthcare Provider Details

I. General information

NPI: 1104937374
Provider Name (Legal Business Name): ELIZABETH ANN HUTCHINGS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY S-116-6EAST
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY S-116-6EAST
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-6558
  • Fax: 206-277-4731
Mailing address:
  • Phone: 206-277-6558
  • Fax: 206-277-4731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001908
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: