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General NPI Number Information
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NPI Number | 1619743234
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Entity Type | Individual
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Provider Name | WHITNEY L. STUBBE MSW
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Gender | Female
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 606 MEDICAL PKWY
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City | ENTERPRISE
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State | OR
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Zip | 97828-5140
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Country | US
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Telephone | 541-512-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 5441 S MACADAM AVE STE R
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City | PORTLAND
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State | OR
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Zip | 97239-6106
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Country | US
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Telephone | 208-914-3068
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 24-QMHP-R-3001
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW-38664
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-44546
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A15486
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License Number State | OR
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