Individual
JOHN-BRIAN WYCKOFF WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM, PSS, LMT
Contact information
Practice address
971 SW WALNUT ST, HILLSBORO, OR 97123-5651
(503) 640-5297
Mailing address
3872 COHO CIR, FOREST GROVE, OR 97116-3096
(503) 313-0070
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000105572
OR
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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