Basic Information
| Provider Information | |||||||||
| NPI: | 1730130592 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTCHINSON | ||||||||
| FirstName: | BYRON | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16233 SYLVESTER RD #G10 | ||||||||
| Address2: | HIGHLINE FOOT ANKLE CLINIC | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062426553 | ||||||||
| FaxNumber: | 2062460468 | ||||||||
| Practice Location | |||||||||
| Address1: | 16233 SYLVESTER RD #G10 | ||||||||
| Address2: | HIGHLINE FOOT ANKLE CLINIC | ||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062426553 | ||||||||
| FaxNumber: | 2062460468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 06/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | PO00000318 | WA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 0219732 | 01 | WA | STATE L&I | OTHER | 251020 | 01 | WA | STATE L&I | OTHER |