IndividualActive
John Hautala, M.D.
NPI 1174664130 · Pediatric Adolescent Medicine Physician · Fircrest, WA
Provider details
- NPI number
- 1174664130
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD00019059 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1033 Regents Blvd
Suite 102
Fircrest, WA 98466-6045
Phone: (253) 564-1115
Fax: (253) 565-4552
Approximate (ZIP-level) locationGet directions
Mailing address
1033 Regents Blvd
Fircrest, WA 98466-6045
Registry dates
- Enumerated
- 2007-02-10
- Last updated
- 2023-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.