Provider Demographics
NPI:1982379905
Name:SCOTT, WHITNEY (IBCLC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 S AINSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3108
Mailing Address - Country:US
Mailing Address - Phone:253-999-8081
Mailing Address - Fax:
Practice Address - Street 1:539 BROADWAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3907
Practice Address - Country:US
Practice Address - Phone:253-448-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL-157546174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAL-157546OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS