Provider Demographics
NPI:1194930156
Name:WHITMAN, TERRY ALLYN (PHD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALLYN
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CASCADE PL
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3126
Mailing Address - Country:US
Mailing Address - Phone:360-391-2496
Mailing Address - Fax:
Practice Address - Street 1:160 CASCADE PL
Practice Address - Street 2:SUITE 222
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3126
Practice Address - Country:US
Practice Address - Phone:360-391-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY1453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist