Provider Demographics
NPI:1922128024
Name:NEWTON, WHITNEY CHARLENE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:CHARLENE
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DIVISION ST SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6542
Mailing Address - Country:US
Mailing Address - Phone:360-870-7635
Mailing Address - Fax:
Practice Address - Street 1:2417 PACIFIC AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2052
Practice Address - Country:US
Practice Address - Phone:360-870-7635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019985225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist