Individual
WHITNEY WAKEFIELD WRISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 WASHINGTON ST STE 105, VANCOUVER, WA 98660
(360) 816-7380
Mailing address
700 WASHINGTON ST STE 105, VANCOUVER, WA 98660-3181
(360) 816-7380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60634564
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60634564
PHYSICIAN ASSISTANT LICENSE
WA
Enumeration date
02/23/2010
Last updated
03/07/2023
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