Individual
SEAN RAE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 W PIONEER AVE, MONTESANO, WA 98563-4323
(360) 637-8108
(360) 637-8709
Mailing address
501 W PIONEER AVE, MONTESANO, WA 98563-4323
(360) 637-8108
(360) 637-8709
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60082203
WA
208000000X
Pediatrics Physician
81719
AZ
208000000X
Pediatrics Physician
MD60082203
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689027328
GROUP NPI
WA
01
—
1912130006
GROUP NPI
WA
01
—
81719
TRAINING PERMIT
AZ
Enumeration date
12/18/2007
Last updated
11/06/2023
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