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General NPI Number Information
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NPI Number | 1063224368
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Entity Type | Organization
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Legal Business Name | WHOLE PERSON WELL CARE, PLLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 12906 SE 201ST ST
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City | KENT
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State | WA
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Zip | 98031-1704
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Country | US
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Telephone | 203-218-2225
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Fax | 253-248-6132
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Provider Business Mailing Address
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Address Line | 12906 SE 201ST ST
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City | KENT
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State | WA
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Zip | 98031-1704
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Country | US
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Telephone | 203-218-2225
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Fax | 253-248-6132
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Authorized Official
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Title or Position | CEO/OWNER
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Name | CAYLIN CHENEY
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Credential | ARNP
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Telephone | 203-218-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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