Provider Demographics
NPI:1528231495
Name:HUTCHESON, ANN (PSYD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:BLALOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:19927 UNIMAK CIRCLE
Mailing Address - Street 2:AHUTCHESONAK@GMAIL.COM
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-5143
Mailing Address - Country:US
Mailing Address - Phone:907-242-8456
Mailing Address - Fax:
Practice Address - Street 1:16535 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5143
Practice Address - Country:US
Practice Address - Phone:503-649-5651
Practice Address - Fax:503-649-7405
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK241492103TC0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR210855Medicaid