NICOLE GRACE WHISKEYJACK (NPI# 1841809134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841809134 |
| Entity Type | Individual |
| Full Name | NICOLE GRACE WHISKEYJACK |
| Credential | CRM |
| Practice Address |
46314 Timine Way Pendleton OR 97801-9417 |
| Mailing Address |
Po Box 160 Pendleton OR 97801-0160 |
| Practice Telephone | 5412408740 |
| Practice Fax Number | 5412408754 |
| Mailing Telephone | 5419669830 |
| Mailing Fax Number | 5412408754 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 20-CRM-173 | OR | Other Service Providers |
| Street Address |
46314 TIMINE WAY |
| City | PENDLETON |
| State | OR |
| Zip Code | 97801-9417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574087 | John A Eaton | Pharmacist | 46314 Timine Way, Pendleton, OR 97801 | 2005-11-07 |
| 1164029393 | Tina M Haynie | Nurse's Aide | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-10-01 |
| 1689288227 | Kolin M Craig | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-09-01 |
| 1205446663 | Vivian June Shaw | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-31 |
| 1629687876 | Rachel Marie Hoptowit | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1376166876 | Andrew David Laffie | Counselor | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-05-19 |
| 1447884762 | Yellowhawk Tribal Health Center | Case Management | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-02-25 |
| 1740845973 | Robert K Bill | Peer Specialist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2019-05-02 |
| 1568027845 | Tiffany A Legore | Dental Hygienist | 46314 Timine Way, Pendleton, OR 97801-9417 | 2019-05-02 |
| 1144794256 | Dusty Lynn Dressler | Dietitian, Registered | 46314 Timine Way, Pendleton, OR 97801-9417 | 2019-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720637119 | Yvonne Walker | Technician | 821 Se 9th St, Pendleton, OR 97801 | 2019-09-09 |
| 1083262703 | Praxis Medical Group Inc | Family Medicine | 2450 Sw Perkins Avenue, Pendleton, OR 97801 | 2019-08-27 |
| 1255826012 | Cosmas Chukwuemeka Nwerem Jr. | Pharmacist | 1900 Sw Court Place, Pendleton, OR 97801 | 2018-06-25 |
| 1689166811 | Helene Danielle Kuhn | Counselor | 4700 Nw Pioneer Pl, Pendleton, OR 97801 | 2018-06-04 |
| 1801302849 | Shawna L. All | Massage Therapist | 24 Se Emigrant Ave., Pendleton, OR 97801 | 2017-12-27 |
| 1033649256 | Sean Collins | Pharmacist | 203 Sw 20th St, Pendleton, OR 97801 | 2017-06-20 |
| 1073974796 | Channon M Baker | Peer Specialist | 7525 Westgate Bldg #2, Pendleton Creek Crisis Stabilization Unit, Pendleton, OR 97801 | 2016-03-08 |
| 1689034357 | Carre Biegel | Counselor | 17 Sw Frazer St, Ste 282, Pendleton, OR 97801 | 2016-02-24 |
| 1073995429 | Jessica Suzanne Pedersen | Massage Therapist | 812 Nw 12th St, Pendleton, OR 97801 | 2015-06-22 |
| 1861736373 | Christina Northern Northerhn | Social Worker | 331 Se 2nd Street, Pendleton, OR 97801 | 2012-11-21 |
| Find all providers in zip 97801 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446663 | Vivian June Shaw | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-31 |
| 1629687876 | Rachel Marie Hoptowit | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1750864229 | Abelardo Lozano | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2018-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598299729 | Sarah Rebecca Miller | Prevention Professional | 16493 Bluewood Pl # 5, La Pine, OR 97739-7526 | 2017-04-13 |
| 1376083121 | Caroline Jean Caulfield | Prevention Professional | 14232 Se Mill Ct, Portland, OR 97233-2370 | 2017-02-27 |
| 1568002392 | Jennifer Liana Siegel | Prevention Professional | 1312 Sw Washington St, Portland, OR 97205-2327 | 2020-01-09 |
| 1558897181 | Christina Evans Gagosian | Prevention Professional | 10300 Sw Greenburg Rd, Suite 410, Portland, OR 97223-5410 | 2017-05-02 |
| 1558892471 | Kelly Mcmullen | Prevention Professional | 819 Se Morrison St, Suite 140, Portland, OR 97214-6307 | 2017-03-22 |
| 1194260927 | Forwardstride | Prevention Professional | 18218 Sw Horse Tale Dr, Beaverton, OR 97007-9789 | 2017-01-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.