Brooke Whiting, LE
Technician, Other in Gresham, OR. Individual provider (NPI-1).
NPI number1669242574
StatusActive
Last updated in NPPESJan 3, 2024
Details
- NPI
- 1669242574
- Entity type
- Individual (NPI-1)
- Name
- Brooke Whiting
- Credential
- LE
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 3, 2024
- Certification date
- Jan 3, 2024
- Last updated
- Jan 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | E-10238354 | OR | Yes |
| 175T00000X | Peer Specialist | E-10238354 | OR |
Practice location
718 N Main AveGresham, OR 97030-7229
Phone 971-666-7795
Mailing address
21960 Ne Chinook Way Apt AFairview, OR 97024-2627
Phone 503-810-7202
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