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NPI Code Detail

MEDICARE: CHRISTOPHER WHITE CADC I

MEDICARE: CHRISTOPHER WHITE CADC I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor11-03-49OR

General Provider Information

NPI Number : 1790106375
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER WHITE CADC I
Provider Business Mailing Address
First Line : 1520 TYLER ST APT 2
Second Line :
City : EUGENE
State : OR
Zip : 97402-3969
Country : US
Telephone Number : 805-704-0447
Fax Number :
Provider Business Practice Location Address
First Line : 1461 OAK ST
Second Line :
City : EUGENE
State : OR
Zip : 97401-4007
Country : US
Telephone Number : 541-687-9141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2013
Last Update Date : 12/26/2013

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Directions to “ CHRISTOPHER WHITE CADC I” Practice Location

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