Individual
GREGG MICHAEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222
(503) 513-8300
Mailing address
P.O. BOX 2817, PORTLAND, OR 97208
(954) 545-0337
(954) 545-3497
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200360037CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
097000628RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100440
—
OR
01
—
865351001
BLUE CROSS
OR
Enumeration date
06/28/2006
Last updated
08/17/2018
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