Provider Demographics
NPI:1154741700
Name:FOLEY-HUTSELL, KATELINN CHELSEA (LMP)
Entity type:Individual
Prefix:
First Name:KATELINN
Middle Name:CHELSEA
Last Name:FOLEY-HUTSELL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3009
Mailing Address - Country:US
Mailing Address - Phone:509-525-3336
Mailing Address - Fax:509-525-3337
Practice Address - Street 1:2 E POPLAR ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3009
Practice Address - Country:US
Practice Address - Phone:509-525-3336
Practice Address - Fax:509-525-3337
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60342423225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist