Provider Demographics
NPI:1588496434
Name:AUCUTT, ASHLEY RYAN
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RYAN
Last Name:AUCUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E HIGHWAY 902 APT A102
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-4902
Mailing Address - Country:US
Mailing Address - Phone:509-406-0378
Mailing Address - Fax:
Practice Address - Street 1:1106 WASHINGTON STREET
Practice Address - Street 2:BUILDING 200 PHYSICAL EDUCATION CLASSROOM
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004
Practice Address - Country:US
Practice Address - Phone:509-359-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program