Healthcare Provider Details

I. General information

NPI: 1164509196
Provider Name (Legal Business Name): LAURIE A. KUTRICH CD, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S MILLER ST
WENATCHEE WA
98801-3201
US

IV. Provider business mailing address

1201 S. MILLER CENTRAL WASHINGTON HOSPITAL
WENATCHEE WA
98801-3201
US

V. Phone/Fax

Practice location:
  • Phone: 509-662-1511
  • Fax: 509-665-6261
Mailing address:
  • Phone: 509-662-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI00001860
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: