Jack White, CRM, THW
Jack White, CRM, THW is a Peer Specialist in Coos Bay, Oregon. Licensed in Oregon. Registered with an NPI since 2022.
- Licensed in
- OR
- In the registry since
- 2022
Practice location Address checks out
1741 Newmark AveCoos Bay, OR 97420-4704
Phone: (541) 851-7151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 22-CRM-1099 (OR) |
|---|
Record details
| NPI number | 1407578891 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CRM , THW |
| Sole proprietor | No |
| NPI enumerated | September 13, 2022 |
| Last updated in NPPES | September 13, 2022 |
| Certification date | September 13, 2022 |
| Mailing address | 155 S Empire Blvd, Coos Bay, OR 97420-3374 |
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