Individual
DIKEESHEA WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1952 SE 122ND AVE, PORTLAND, OR 97233-1304
(503) 726-3690
Mailing address
1952 SE 122ND AVE, PORTLAND, OR 97233-1304
(503) 726-3690
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/02/2019
Last updated
05/05/2023
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