Individual provider · Type 1 NPI

Theodore James Gutterud

Student in an Organized Health Care Education/Training Program · Maple Valley, WA

NPI number 1811804313 Active

Practice location

27203 216th Ave SE Ste 5
Maple Valley, WA 98038-3273

Mailing address

22870 SE Fir St Apt A301
Black Diamond, WA 98010-5142

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1811804313

Theodore James Gutterud's National Provider Identifier is 1811804313, issued on Aug 27, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Maple Valley, WA. The record was last updated on Aug 27, 2026.