Individual
BRENNA WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Mailing address
7239 SAND POINT WAY NE APT 205, SEATTLE, WA 98115-6314
(503) 887-9578
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/11/2016
Last updated
11/09/2022
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