Provider Demographics
NPI:1003086331
Name:WHITE, JAMES MACDONALD (LMP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MACDONALD
Last Name:WHITE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1827
Mailing Address - Country:US
Mailing Address - Phone:509-638-5751
Mailing Address - Fax:
Practice Address - Street 1:611 W 26TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-1827
Practice Address - Country:US
Practice Address - Phone:509-638-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025229172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist