Dora Whittaker, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

00058765 Issued in WA

Practice address

170 Moon Valley Dr
Quilcene, WA 98376-0411

Phone

(360) 301-0478

Fax

(360) 765-3241

NPI assigned

Oct 3, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Heron Skilled Nursing Services

  • Registered Nurse
  • Quilcene, WA
  • NPI 1205179256
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1346677416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411",
            "address_2": "165 MONN VALLEY RD",
            "city": "QUILCENE",
            "state": "WA",
            "postal_code": "983760411",
            "telephone_number": "360-301-0478",
            "fax_number": "360-765-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MOON VALLEY DR",
            "city": "QUILCENE",
            "state": "WA",
            "postal_code": "983760411",
            "telephone_number": "360-301-0478",
            "fax_number": "360-765-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "DORA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00058765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve D Pate, ARNP
• Quilcene School District
• Quilcene Volunteer Fire Dept Inc
• Shauna Coleman Enterprises Inc
• Heather Spencer, L.AC.
• Shauna Woodmansee-Coleman, P.T.

• Registered Nurse in Quilcene, WA
• Providers in Quilcene, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.