Healthcare Provider Details
I. General information
NPI: 1407371784
Provider Name (Legal Business Name): WHITNEY IPARRAGUIRRE BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/08/2017
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4455 NE HIGHWAY 20
CORVALLIS OR
97330-9695
US
IV. Provider business mailing address
185 SW KALMIA ST STE 3
JUNCTION CITY OR
97448-6804
US
V. Phone/Fax
- Phone: 541-758-5900
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: