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NPI Code Detail

MEDICARE: J. HARRISON WHITCOMB LCSW

MEDICARE: J. HARRISON WHITCOMB LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34536TX

General Provider Information

NPI Number : 1275541989
Entity Type Code : Individual
Provider Name (Legal Business Name) : J. HARRISON WHITCOMB LCSW
Provider Business Mailing Address
First Line : 702 SUNSET DR
Second Line :
City : ONTARIO
State : OR
Zip : 97914-3121
Country : US
Telephone Number : 541-889-9167
Fax Number :
Provider Business Practice Location Address
First Line : 702 SUNSET DR
Second Line :
City : ONTARIO
State : OR
Zip : 97914-3121
Country : US
Telephone Number : 541-889-9167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 07/31/2007

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