Individual
JOEY LEE WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC 2
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
4429 FERGUS AVE, EUGENE, OR 97402-1769
(541) 653-1287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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