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Individual

MR. JODY LYNN WHITEHAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 588-5342
Mailing address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 588-5342

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200940069RN
OR
163WR0400X
Rehabilitation Registered Nurse
200940069RN
OR

Other

Enumeration date
02/03/2009
Last updated
02/03/2009
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