Healthcare Provider Details

I. General information

NPI: 1720859572
Provider Name (Legal Business Name): SKYLER L HUTCHENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SKYLER L SCHRUP

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 NE 7TH AVE STE C116
VANCOUVER WA
98685-4528
US

IV. Provider business mailing address

236 LAVERNE DR
KALAMA WA
98625-9830
US

V. Phone/Fax

Practice location:
  • Phone: 541-510-7519
  • Fax:
Mailing address:
  • Phone: 541-510-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: