Individual
MS. DIANNE LOUISE KUTZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5456
(425) 869-7201
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30001181
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018078
—
WA
01
—
139617
LABOR & INDUSTRIES
WA
01
—
200012131
MEDICARE RAILROAD
WA
01
—
7023KU
BLUE SHIELD
WA
05
—
9607276
—
WA
Enumeration date
11/16/2005
Last updated
05/22/2015
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