Provider Demographics
NPI:1609532852
Name:WHALEN, BRIDGET A (OT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:A
Last Name:WHALEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26601 MANCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7822
Mailing Address - Country:US
Mailing Address - Phone:716-385-2495
Mailing Address - Fax:
Practice Address - Street 1:26601 MANCHESTER CT
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7822
Practice Address - Country:US
Practice Address - Phone:716-385-2495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist