Provider Demographics
NPI:1720406499
Name:GIVEN, WHITNEY I
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:GIVEN
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16340 NE 83RD ST
Mailing Address - Street 2:F130
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3866
Mailing Address - Country:US
Mailing Address - Phone:407-761-3740
Mailing Address - Fax:
Practice Address - Street 1:16340 NE 83RD ST
Practice Address - Street 2:F130
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3866
Practice Address - Country:US
Practice Address - Phone:407-761-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60420629224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant