Provider Demographics
NPI:1366084907
Name:WHITEMAN, EMALEE RAYLENE (MA 61006423)
Entity type:Individual
Prefix:
First Name:EMALEE
Middle Name:RAYLENE
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:MA 61006423
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4702
Mailing Address - Country:US
Mailing Address - Phone:360-734-9555
Mailing Address - Fax:
Practice Address - Street 1:1756 IOWA ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-4702
Practice Address - Country:US
Practice Address - Phone:360-734-9555
Practice Address - Fax:360-734-9556
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61006423225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist