Provider Demographics
NPI:1639297831
Name:PAYNE-MCWHORTER, LINDA S (LMP, NCMT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:PAYNE-MCWHORTER
Suffix:
Gender:F
Credentials:LMP, NCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3927
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-3927
Mailing Address - Country:US
Mailing Address - Phone:360-731-6853
Mailing Address - Fax:360-792-0421
Practice Address - Street 1:343 N WYCOFF AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-4014
Practice Address - Country:US
Practice Address - Phone:360-731-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023617225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist