Provider Demographics
NPI:1871183442
Name:BARBER, WHITNEY L
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:L
Last Name:BARBER
Suffix:
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 1:21662 SE 239TH PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5505
Mailing Address - Country:US
Mailing Address - Phone:253-414-2369
Mailing Address - Fax:
Practice Address - Street 1:26830 MAPLE VALLEY BLACK DIAMOND RD SE STE A-7
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8309
Practice Address - Country:US
Practice Address - Phone:425-433-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60483449225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist