Provider Demographics
NPI:1598108417
Name:GRIZZLE, WHITNEY ELIZABETH (LMT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELIZABETH
Last Name:GRIZZLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 165TH PL NE APT AA1082
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6338
Mailing Address - Country:US
Mailing Address - Phone:512-800-0951
Mailing Address - Fax:
Practice Address - Street 1:3928 165TH PL NE APT AA1082
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6338
Practice Address - Country:US
Practice Address - Phone:512-800-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23641225700000X
TXMT114870225700000X
CA26859225700000X
WAMA60987873225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist