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JACK WHITE CRM , THW
NPI 1407578891
Peer Specialist in Coos Bay, OR

Active since September 13, 2022
1741 NEWMARK AVE, COOS BAY, OR 97420(541) 851-7151 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack White Crm , Thw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK WHITE CRM , THW (NPI 1407578891) is an individual peer specialist in Coos Bay, Oregon, licensed in Oregon (22-CRM-1099) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1407578891
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameJACK WHITECredential: CRM , THW
Location Address1741 NEWMARK AVECoos Bay, OR 97420-4704
Mailing Address155 S Empire BlvdCoos Bay, OR 97420-3374 · (541) 851-7151
Phone(541) 851-7151
Sole ProprietorNo
Enumeration DateSeptember 13, 2022
NPPES CertifiedSeptember 13, 2022
✔ NPI 1407578891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 22-CRM-1099
Definition
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.
1741 NEWMARK AVE, Coos Bay, OR 97420
Open in Google Maps ↗

Other Identifiers 1

OtherTHW000107022OR · Thw

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA JEAN MANSKE
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 294-4215
LAICEE EICHLER CADCII, QMHAI
Counselor (Addiction (Substance Use Disorder))
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 756-3111
RHONDA RAWE
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 707-7769
JARROD ANTHONY OLSEN CRM
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 435-1152
KELLY ALLEEN JONES
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 404-4408
THERESA KEYS CRM, PWS
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (541) 622-0066
ANNETTE JANE MILES PWS
Peer Specialist
1741 NEWMARK AVE
COOS BAY, OR 97420
Coos County (458) 710-8184

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack White's NPI number?

The NPI number for Jack White is 1407578891. It was assigned to this individual provider in the NPPES registry on September 13, 2022.

Where is Jack White located?

Jack White practices at 1741 Newmark Ave, Coos Bay, OR 97420. The listed phone number is (541) 851-7151.

What is Jack White's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Jack White was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.