Provider Demographics
NPI:1922406644
Name:DROLLETTE, WHITNEY (LMP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:DROLLETTE
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 1:3656 NW MUNSON ST
Mailing Address - Street 2:#1
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3656 NW MUNSON ST
Practice Address - Street 2:#1
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9140
Practice Address - Country:US
Practice Address - Phone:360-731-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60513357225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist