Hautala, John Michael

Hautala, John Michael is an individual health care provider with primary practice located at 1033 Regents Blvd Suite 102, Fircrest WA 98466-6045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Hautala, John Michael can be contacted via phone (253) 564-1115.

Contact Information

Primary practice address
1033 Regents Blvd Suite 102 Fircrest WA 98466-6045
Phone: (253) 564-1115
Fax: (253) 565-4552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MD00019059 Washington

Profile Details

NPI number 1174664130
LBN Legal business name Hautala, John Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2007
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174664130 NPPES
Washington MEDICAID 1783703
Washington Other MD00019059
Washington Other 108917
Washington Other HA7840

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