Provider Demographics
NPI:1952573487
Name:WHITTECAR, KAYO (LMP)
Entity Type:Individual
Prefix:MRS
First Name:KAYO
Middle Name:
Last Name:WHITTECAR
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 1:3002 NE 127TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4415
Mailing Address - Country:US
Mailing Address - Phone:206-306-2494
Mailing Address - Fax:206-306-9351
Practice Address - Street 1:3002 NE 127TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4415
Practice Address - Country:US
Practice Address - Phone:206-306-2494
Practice Address - Fax:206-306-9351
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025038172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist