Provider Demographics
NPI:1144767989
Name:FISCHER-WHALEY, FAITH (LMP)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:FISCHER-WHALEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 TOPAZ CT
Mailing Address - Street 2:
Mailing Address - City:WINLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98596-9119
Mailing Address - Country:US
Mailing Address - Phone:303-807-2668
Mailing Address - Fax:
Practice Address - Street 1:114 TOPAZ CT
Practice Address - Street 2:
Practice Address - City:WINLOCK
Practice Address - State:WA
Practice Address - Zip Code:98596-9119
Practice Address - Country:US
Practice Address - Phone:303-807-2668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60684774225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist