Individual
MR. MARK EDWARD WHITNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2446 NW HUMMINGBIRD DR, CORVALLIS, OR 97330-2280
(208) 477-7194
Mailing address
2446 NW HUMMINGBIRD DR, CORVALLIS, OR 97330-2280
(208) 477-7194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
L8340
OR
104100000X
Social Worker
LCSW-3197
ID
104100000X
Social Worker
LW60169256
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500775581
—
OR
Enumeration date
08/14/2006
Last updated
12/28/2023
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