Healthcare Provider Details

I. General information

NPI: 1982933776
Provider Name (Legal Business Name): RITA L WHITMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20817 17TH AVE S
DES MOINES WA
98198-7665
US

IV. Provider business mailing address

20817 17TH AVE S
DES MOINES WA
98198-7665
US

V. Phone/Fax

Practice location:
  • Phone: 206-257-6275
  • Fax: 206-257-6308
Mailing address:
  • Phone: 206-257-6275
  • Fax: 206-257-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337525-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60410362
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number443891-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60412640
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: