Provider Demographics
NPI:1740722206
Name:WHITE, RHENA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:RHENA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:RHENA
Other - Middle Name:
Other - Last Name:TURNBOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4005 N WINNIFRED ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-2712
Mailing Address - Country:US
Mailing Address - Phone:206-992-4200
Mailing Address - Fax:
Practice Address - Street 1:3680 S CEDAR ST STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5728
Practice Address - Country:US
Practice Address - Phone:253-289-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA111524501Medicaid