Active NPI
Brooke Whiting, LE
- Other Technician
- Gresham, OR
National Provider Identifier
1669242574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- E-10238354
- Practice address
- 718 N Main Ave
Gresham, OR 97030-7229 - Phone
- (971) 666-7795
- NPI assigned
- Jan 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | E-10238354 | OR | |
| Other Technician | 247200000X | E-10238354 | OR | Primary |
Addresses
Primary practice location
718 N Main Ave
Gresham, OR 97030-7229
Mailing address
21960 NE Chinook Way Apt a
Fairview, OR 97024-2627
Phone (503) 810-7202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-10238354 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1669242574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21960 NE CHINOOK WAY APT A",
"city": "FAIRVIEW",
"state": "OR",
"postal_code": "970242627",
"telephone_number": "503-810-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 N MAIN AVE",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307229",
"telephone_number": "971-666-7795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITING",
"first_name": "BROOKE",
"credential": "LE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-03",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "E-10238354",
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OR",
"license": "E-10238354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.