Provider Demographics
NPI:1508260050
Name:JENKINS, WHITNEY (PHD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 130TH AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1757
Mailing Address - Country:US
Mailing Address - Phone:425-298-7193
Mailing Address - Fax:425-702-0600
Practice Address - Street 1:2310 130TH AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1757
Practice Address - Country:US
Practice Address - Phone:425-298-7193
Practice Address - Fax:425-702-0600
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X
WAPY.60761909103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral