Provider Demographics
NPI:1730130592
Name:HUTCHINSON, BYRON L (DPM)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:L
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16233 SYLVESTER RD #G10
Mailing Address - Street 2:HIGHLINE FOOT ANKLE CLINIC
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-242-6553
Mailing Address - Fax:206-246-0468
Practice Address - Street 1:16233 SYLVESTER RD #G10
Practice Address - Street 2:HIGHLINE FOOT ANKLE CLINIC
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-242-6553
Practice Address - Fax:206-246-0468
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO00000318213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0219732OtherSTATE L&I
WA251020OtherSTATE L&I
T01639Medicare UPIN
WA251020OtherSTATE L&I
G000102418Medicare ID - Type Unspecified