Individual
TANA MAE WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 PELLY AVE N, RENTON, WA 98057-5714
(425) 271-2389
(425) 271-2389
Mailing address
121 PELLY AVE N, RENTON, WA 98057-5714
(425) 271-2389
(425) 271-2389
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010537
WA
Other
Enumeration date
04/06/2007
Last updated
10/09/2008
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