JASON HAUTALA (NPI# 1750927836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750927836 |
| Entity Type | Individual |
| Full Name | JASON HAUTALA |
| Practice Address |
307 W Cota St Shelton WA 98584-2265 |
| Practice Telephone | 3606663808 |
| Practice Fax Number | 5102176559 |
| Mailing Telephone | 3606663808 |
| Mailing Fax Number | 5102176559 |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2019-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN00123238 | WA | Nursing Service Providers |
| Street Address |
307 W COTA ST |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933105 | Joshua Ireland | Psychologist | 307 W Cota St, Shelton, WA 98584-2265 | 2019-10-08 |
| 1528668787 | Ricardo De Jesus Funes | Social Worker | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-27 |
| 1841899713 | Mary Katherine Twidwell | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-22 |
| 1871191676 | Samantha Lynn Thompson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-10-14 |
| 1316559131 | Kerry Rose Johnson | Counselor | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-21 |
| 1013529122 | Jennifer A Sagen | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1629680731 | Akashia Milsap | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1457963571 | Shane Micheal Taylor | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-19 |
| 1740890318 | Eric William Rehwaldt | Behavior Technician | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| 1013527654 | Tracy Lynn Wright | Licensed Practical Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619514700 | Babynette W Caras | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2019-12-08 |
| 1710523568 | Kristofer Alston | Registered Nurse | 307 W Cota St, Shelton, WA 98584-2265 | 2019-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848561 | Heidi Lynnette Kangas | Registered Nurse | 1128 Broadway St, Longview, WA 98632-3831 | 2020-10-09 |
| 1184235418 | Afuthal Ndugwa Ssemakula | Registered Nurse | 614 Riverside Dr Apt B103, Wenatchee, WA 98801-6154 | 2020-08-11 |
| 1225671969 | Virginia Hadley | Registered Nurse | 3436 Mary Elder Rd Ne # E&t, Olympia, WA 98506-5050 | 2019-10-25 |
| 1114569464 | Diana Wilcox | Registered Nurse | 2011 Mottman Rd Sw, Tumwater, WA 98512-6218 | 2019-10-08 |
| 1023579430 | Joan Watkins Opyr | Registered Nurse | Telecare North Sound E&t, 7825 North Sound Drive, Sedro-woolley, WA 98273 | 2019-03-28 |
| 1609351717 | Charlotte Gex Morgan | Registered Nurse | 57 W Main St Ste 260, Chehalis, WA 98532-4815 | 2018-09-25 |
| 1821571050 | Kimberlee Susan Long | Registered Nurse | 4104 Puffin Rd, Ferndale, WA 98248-9579 | 2018-09-13 |
| 1235669607 | Bridget Lash | Registered Nurse | 4319 Tyler Way, Anacortes, WA 98221-3215 | 2017-06-18 |
| 1174072623 | Vicki Boothe | Registered Nurse | 26254 Ne Barrett Rd, Kingston, WA 98346-9342 | 2016-09-26 |
| 1265981997 | Lorraine Jeanette Diricco | Registered Nurse | 1717 W Francis Ave Ste 204, Spokane, WA 99205 | 2016-09-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JASON HAUTALA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.