Individual
SHELLY WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 SE HAILEY AVE STE 204, PENDLETON, OR 97801-3072
(541) 663-4104
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 663-4104
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-26-6330
OR
175T00000X
Peer Specialist
Primary
24-CRM-4013
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/22/2024
Last updated
01/22/2026
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