Healthcare Provider Details

I. General information

NPI: 1699753186
Provider Name (Legal Business Name): KATHLEEN ANN KUTSCHER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040 REID ST., ATTN: MCHJ-QCR
TACOMA WA
98431-0001
US

IV. Provider business mailing address

10907 62ND ST E
PUYALLUP WA
98372-2738
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1552
  • Fax: 866-478-2497
Mailing address:
  • Phone: 253-770-9253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW00004859
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00004859
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: