Individual provider · Type 1 NPI

Jack White, CRM, THW

Peer Specialist · Coos Bay, OR

NPI number 1407578891 Active

Practice location

1741 Newmark Ave
Coos Bay, OR 97420-4704

Call (541) 851-7151 Map

Mailing address

155 S Empire Blvd
Coos Bay, OR 97420-3374

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000X22-CRM-1099 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1407578891

Jack White, CRM, THW's National Provider Identifier is 1407578891, issued on Sep 13, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Coos Bay, OR. The record was last updated on Sep 13, 2022.