Provider Demographics
NPI:1275960767
Name:WIHLEY, ASHELY L (LMP)
Entity Type:Individual
Prefix:MS
First Name:ASHELY
Middle Name:L
Last Name:WIHLEY
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 1:1318 ELLINOR AVE
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-1121
Mailing Address - Country:US
Mailing Address - Phone:360-229-8456
Mailing Address - Fax:360-426-8300
Practice Address - Street 1:422 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3410
Practice Address - Country:US
Practice Address - Phone:360-426-6325
Practice Address - Fax:360-426-8300
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60192786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist