Provider Demographics
NPI:1346081643
Name:WHITE, SEAN
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 BORGEN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8809
Mailing Address - Country:US
Mailing Address - Phone:253-853-4000
Mailing Address - Fax:253-853-4001
Practice Address - Street 1:10516 SILVERDALE WAY NW STE 110B
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8745
Practice Address - Country:US
Practice Address - Phone:360-633-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist