Provider Demographics
NPI:1528454865
Name:HUTTON, JANET THEA (OTR/L)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:THEA
Last Name:HUTTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 128TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8328
Mailing Address - Country:US
Mailing Address - Phone:425-802-2488
Mailing Address - Fax:425-822-6616
Practice Address - Street 1:7329 128TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8328
Practice Address - Country:US
Practice Address - Phone:425-802-2488
Practice Address - Fax:425-822-6616
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00001238172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAOT 00001238OtherOT LICENSE
IL000000080911OtherAOTA MEMBERSHIP