Provider Demographics
NPI:1447782644
Name:HUTTON, JILLIAN BARTLETT
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:BARTLETT
Last Name:HUTTON
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 1:434 SW 297TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3553
Mailing Address - Country:US
Mailing Address - Phone:316-347-4480
Mailing Address - Fax:
Practice Address - Street 1:434 SW 297TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-3553
Practice Address - Country:US
Practice Address - Phone:316-347-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician