Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 7936 | OR |
NPI | 1003035387 |
---|---|
Provider Name | Ms. Kathleen Mari Whaley |
First Address | Federal Way, WA 98003-3722 |
Second Address | Federal Way, WA 98003-3722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |