Provider Demographics
NPI:1407205677
Name:WHITTINGTON, MICHAEL JOHN AVERY
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN AVERY
Last Name:WHITTINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MEJOAN
Other - Middle Name:
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4219 SW JUNEAU ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1621
Mailing Address - Country:US
Mailing Address - Phone:206-207-5395
Mailing Address - Fax:
Practice Address - Street 1:3214 W MCGRAW ST
Practice Address - Street 2:SUITE 212
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-3239
Practice Address - Country:US
Practice Address - Phone:206-453-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist