Basic Information
| Provider Information | |||||||||
| NPI: | 1871581603 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTCHASON | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2901 BRIDGEPORT WAY W | ||||||||
| Address2: | |||||||||
| City: | UNIVERSITY PLACE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984664614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535347000 | ||||||||
| FaxNumber: | 2535347099 | ||||||||
| Practice Location | |||||||||
| Address1: | 2901 BRIDGEPORT WAY W | ||||||||
| Address2: | |||||||||
| City: | UNIVERSITY PLACE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984664614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535347000 | ||||||||
| FaxNumber: | 2535347099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 09/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP30003974 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 0263015 | 01 | WA | STATE L&I | OTHER | 152940 | 01 | L & I | OTHER | 9624180 | 05 | WA | MEDICAID |