Organization
SIDNEY F WHALEY JR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIDNEY F WHALEY JR. MD (PRESIDENT)
(253) 383-1529
Entity
Organization
Contact information
Practice address
314 MLK JR WY #210, TACOMA, WA 98405-4271
(253) 383-1529
(253) 593-4344
Mailing address
314 MLK JR WY #210, TACOMA, WA 98405-4271
(253) 383-1529
(253) 593-4344
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10945
WA
207ND0101X
MOHS-Micrographic Surgery Physician
10945
WA
207ND0900X
Dermatopathology Physician
10945
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1930007
—
WA
01
—
WH4111
REGENCE
—
Enumeration date
01/18/2006
Last updated
10/04/2007
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