Provider Demographics
NPI:1578847109
Name:WHEADON, LINDA D (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:WHEADON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15436 BEL RED RD
Mailing Address - Street 2:STE 100
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5536
Mailing Address - Country:US
Mailing Address - Phone:425-644-4100
Mailing Address - Fax:425-644-4101
Practice Address - Street 1:15436 BEL RED RD
Practice Address - Street 2:STE 100
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5536
Practice Address - Country:US
Practice Address - Phone:425-644-4100
Practice Address - Fax:425-644-4101
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00129041163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health