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General NPI Number Information
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NPI Number | 1588700801
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Entity Type | Individual
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Provider Name | DR. WARREN L WHITNAH
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PINE EAGLE CLINIC 218 N. PINE STREET
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City | HALFWAY
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State | OR
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Zip | 97870
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Country | US
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Telephone | 541-742-6012
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Fax | 541-742-6013
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Provider Business Mailing Address
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Address Line | 35555 SPARTA LN
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City | RICHLAND
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State | OR
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Zip | 97870-6650
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Country | US
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Telephone | 541-893-6012
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Fax | 541-893-6787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4377
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License Number State | OR
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