Provider Demographics
NPI:1417488800
Name:HALE, WHITNEY KAY SHIRLEY (DO)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:KAY SHIRLEY
Last Name:HALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:KAY
Other - Last Name:SHIRLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5109 SUMMITVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2858
Mailing Address - Country:US
Mailing Address - Phone:509-907-6300
Mailing Address - Fax:509-907-6310
Practice Address - Street 1:5109 SUMMITVIEW AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2858
Practice Address - Country:US
Practice Address - Phone:509-907-6300
Practice Address - Fax:509-907-6310
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61450723207Q00000X
390200000X
WAOL61067942207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program