Provider Demographics
NPI:1841779360
Name:WHALEN, SEAN PATRICK (MA)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:WHALEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 PACIFIC AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3121
Mailing Address - Country:US
Mailing Address - Phone:253-394-4313
Mailing Address - Fax:
Practice Address - Street 1:1944 PACIFIC AVE STE 309
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3121
Practice Address - Country:US
Practice Address - Phone:253-394-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health