Healthcare Provider Details

I. General information

NPI: 1013298975
Provider Name (Legal Business Name): GREGORY EUGENE WHITING MSW, LSWAIC, CDPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7109 WOODLAWN AVE NE STE 204
SEATTLE WA
98115-5434
US

IV. Provider business mailing address

3040 78TH AVE SE P.O. BOX 253
MERCER ISLAND WA
98040-9998
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-4042
  • Fax:
Mailing address:
  • Phone: 206-486-4042
  • Fax: 206-558-1391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC60301744
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC60301744
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: