Provider Demographics
NPI:1881817633
Name:WHITMONT, ANDREW D (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:WHITMONT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 N 11TH AVE STE 102
Mailing Address - Street 2:YAKIMA
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 N 11TH AVE STE 102
Practice Address - Street 2:YAKIMA
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3085
Practice Address - Country:US
Practice Address - Phone:509-457-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000570103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical