Collin White-pedeaux, is a
Social Worker - Clinical based in Portland, Oregon. Collin White-pedeaux is licensed to practice in * (Not Available) (license number ) and his current practice location is
1825 Ne Glisan St, Portland, Oregon. He can be reached at his office (for appointments etc.) via phone at
(503) 963-7676.
NPI number for Collin White-pedeaux is 1508206996 and his current mailing address is 4101 Ne Division St, 100, Gresham, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508206996.
Healthcare Provider's Profile
| Full Name | Collin White-pedeaux |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1825 Ne Glisan St, Portland, Oregon |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1508206996
- Provider Enumeration Date: 06/28/2013
- Last Update Date: 01/22/2020
Medical Identifiers
Medical identifiers for Collin White-pedeaux such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508206996 | NPI | - | NPPES |
| 274147 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Collin White-pedeaux is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Collin White-pedeaux,
4101 Ne Division St, 100,
Gresham, OR 97030-4617
Ph: (503) 666-3808 | Collin White-pedeaux,
1825 Ne Glisan St,
Portland, OR 97232-2844
Ph: (503) 963-7676 |
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