Look up the most recent NPI and PECOS records

Whitney Black

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011

PECOS Enrollment

Based on the most recent information from CMS, provider Whitney Black is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1659490183
Provider Type
Individual
Full Name
Black, Whitney
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
3/28/2007
Last Updated
10/3/2016

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011

(503) 494-8613

Unlisted Fax

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8613

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD28102 Oregon

Whitney Black

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Teo, Alan Robert

Matthews, Annette Marie

Boehnlein, James Kevin

Kinzie, John Mark

Starr, Kathryn

Maricle, Robert Alan

U'Ren, Richard Cameron

Rodriguez, Mikaela Lea

Wilson, William Harwell

Zhang, James