Kutzke, Dianne Louise

Kutzke, Dianne Louise is an individual health care provider with primary practice located at 3901 Hoyt Ave , Everett WA 98201-4918. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kutzke, Dianne Louise can be contacted via phone (425) 339-5456.

Contact Information

Primary practice address
3901 Hoyt Ave Everett WA 98201-4918
Phone: (425) 339-5456
Fax: (425) 869-7201
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP30001181 Washington

Profile Details

NPI number 1750363628
LBN Legal business name Kutzke, Dianne Louise
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated May 22nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750363628 NPPES
Washington Other 7023KU BLUE SHIELD
Washington MEDICAID 9607276 BLUE SHIELD
Washington Other 139617 BLUE SHIELD
Washington MEDICAID 1018078 BLUE SHIELD
Washington Other 200012131 BLUE SHIELD

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