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Dr. John Michael Hautala, MD
Pediatric Adolescent Medicine Physician in Fircrest, Washington
NPI 1174664130

John Michael Hautala is a Pediatric Adolescent Medicine Physician based in Fircrest, WA and is specialized in Adolescent Medicine. John Michael Hautala practices in Fircrest, WA and has the professional credentials of MD. The NPI Number for John Michael Hautala is 1174664130 and holds a License No. MD00019059 (Washington).

The current practice location address for John Michael Hautala is 1033 Regents Blvd, Fircrest, WA and can be reached out via phone at 253-564-1115 and via fax at 253-565-4552.

Location: 1033 Regents Blvd, Fircrest, WA, 98466-6045
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174664130
Provider Name
John Michael Hautala
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1033 Regents Blvd, Fircrest, WA, 98466-6045
Phone Number
253-564-1115
Fax Number
253-565-4552
Provider Enumeration Date
02/10/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1783703 05 WA
MD00019059 01 WA STATE LICENSE NUMBER
108917 01 WA L&I NUMBER
HA7840 01 WA REGENCE BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1033 Regents Blvd
City
Fircrest
State
Washington
Zip
98466-6045
Phone Number
253-564-1115
Fax Number
253-565-4552
person
Provider Business Mailing Address Details
Address
1033 Regents Blvd
City
Fircrest
State
Washington
Zip
98466-6045
Phone Number
253-564-1115
Fax Number
253-565-4552
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Adolescent Medicine
Taxonomy
2080A0000X
License No.
MD00019059 (Washington)
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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