Healthcare Provider Details

I. General information

NPI: 1659490183
Provider Name (Legal Business Name): WHITNEY BLACK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 SW BEAVERTON HILLSDALE HWY STE 250
BEAVERTON OR
97005-3315
US

IV. Provider business mailing address

9400 SW BEAVERTON HILLSDALE HWY STE 250
BEAVERTON OR
97005-3315
US

V. Phone/Fax

Practice location:
  • Phone: 503-660-3299
  • Fax:
Mailing address:
  • Phone: 503-660-3299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD28102
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: