Provider Demographics
NPI:1194034389
Name:HANDLEY WHALEY, TORI K (LMP)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:K
Last Name:HANDLEY WHALEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:K
Other - Last Name:HANDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:36 AMA PL
Mailing Address - Street 2:
Mailing Address - City:PESHASTIN
Mailing Address - State:WA
Mailing Address - Zip Code:98847-9772
Mailing Address - Country:US
Mailing Address - Phone:509-679-9225
Mailing Address - Fax:
Practice Address - Street 1:36 AMA PL
Practice Address - Street 2:
Practice Address - City:PESHASTIN
Practice Address - State:WA
Practice Address - Zip Code:98847-9772
Practice Address - Country:US
Practice Address - Phone:509-679-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60132956174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist