Provider Demographics
NPI:1821844150
Name:WHITE, HELENA MARIE (LMT)
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:HELENA
Other - Middle Name:MARIE
Other - Last Name:PRINCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:9013 RUVEN ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-7027
Mailing Address - Country:US
Mailing Address - Phone:303-709-6870
Mailing Address - Fax:
Practice Address - Street 1:1724 WESLEY WAY
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-6001
Practice Address - Country:US
Practice Address - Phone:509-839-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61525270225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist