Basic Information
| Provider Information | |||||||||
| NPI: | 1891726089 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTTON | ||||||||
| FirstName: | TAWNA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4815 N ASSEMBLY ST | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992056185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094347768 | ||||||||
| FaxNumber: | 5094347140 | ||||||||
| Practice Location | |||||||||
| Address1: | 4815 N ASSEMBLY ST | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992056185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094347768 | ||||||||
| FaxNumber: | 5094347156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LW00007275 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.