Provider Demographics
NPI:1427026012
Name:DAHMER, WENDY WHIPPLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:WHIPPLE
Last Name:DAHMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:WHIPPLE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:6217 FERNRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-8030
Mailing Address - Country:US
Mailing Address - Phone:727-902-3825
Mailing Address - Fax:
Practice Address - Street 1:4415 COLUMBINE DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8039
Practice Address - Country:US
Practice Address - Phone:360-715-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25062225100000X
NC2111225100000X
WA61046221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7246989Medicaid
NC346623Medicare ID - Type Unspecified