Healthcare Provider Details

I. General information

NPI: 1023702164
Provider Name (Legal Business Name): AUBREY J WHITTIER MSOM LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3217 MERIDIAN AVE E
EDGEWOOD WA
98371-2613
US

IV. Provider business mailing address

3217 MERIDIAN AVE E
EDGEWOOD WA
98371-2613
US

V. Phone/Fax

Practice location:
  • Phone: 253-927-5905
  • Fax: 253-321-0219
Mailing address:
  • Phone: 253-927-5905
  • Fax: 253-321-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC61464324
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: