Provider Demographics
NPI:1487912135
Name:TUTTLE, KATHY LEE (RPH)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LEE
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:TERRI
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:802 134TH ST SW
Mailing Address - Street 2:BLDG C SUITE 140
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-7314
Mailing Address - Country:US
Mailing Address - Phone:800-607-6861
Mailing Address - Fax:800-633-0334
Practice Address - Street 1:802 134TH ST SW
Practice Address - Street 2:BLDG C SUITE 140
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-7314
Practice Address - Country:US
Practice Address - Phone:800-607-6861
Practice Address - Fax:800-633-0334
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019589183500000X
TX31241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist