Healthcare Provider Details

I. General information

NPI: 1588496434
Provider Name (Legal Business Name): ASHLEY RYAN AUCUTT MSAT, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 11TH AVE STE 320
YAKIMA WA
98902-3273
US

IV. Provider business mailing address

7805 TIETON DR
YAKIMA WA
98908-1543
US

V. Phone/Fax

Practice location:
  • Phone: 509-454-8888
  • Fax:
Mailing address:
  • Phone: 509-406-0378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATHL.A1.70151923
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: