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NPI 1699667485

NPI 1699667485 : WHITE RABBIT PROJECT : MILWAUKIE, OR

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General NPI Number Information
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    NPI Number           |    1699667485
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    Entity Type          |    Organization 
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    Legal Business Name  |    WHITE RABBIT PROJECT 
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Dates
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    Enumeration Date     |    07/17/2025
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    Last Update Date     |    07/17/2025
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Provider Practice Location Address
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    Address Line         |    6694 SE MOLT ST 
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    City                 |    MILWAUKIE
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    State                |    OR
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    Zip                  |    97267-3224
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    Country              |    US
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    Telephone            |    503-927-3566
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6694 SE MOLT ST 
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    City                 |    MILWAUKIE
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    State                |    OR
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    Zip                  |    97267-3224
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    Country              |    US
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    Telephone            |    503-927-3566
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     KRISTINA  WOOD 
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    Credential           |    
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    Telephone            |    503-927-3566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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