MEDICARE: DIANE HUTCHESON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	AP30004654	WA

General Provider Information

NPI Number	:	1780915363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANE HUTCHESON ARNP

Provider Business Mailing Address
First Line	:	126 SW 148TH ST
Second Line	:	STE C 100-334
City	:	BURIEN
State	:	WA
Zip	:	98166-1984
Country	:	US
Telephone Number	:	206-841-2126
Fax Number	:	206-932-4856

Provider Business Practice Location Address
First Line	:	6959 CALIFORNIA AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98136-1953
Country	:	US
Telephone Number	:	206-841-2126
Fax Number	:	206-932-4856

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DIANE GRACE HUTCHESON
Credential	:	ARNP
Telephone Number	:	206-841-2126

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	04/21/2010

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