Provider Demographics
NPI:1275292328
Name:BRIAN WHITMER LLC
Entity Type:Organization
Organization Name:BRIAN WHITMER LLC
Other - Org Name:BIG SUN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-849-8119
Mailing Address - Street 1:3234 NE WASCO ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1981
Mailing Address - Country:US
Mailing Address - Phone:503-849-8119
Mailing Address - Fax:503-350-2079
Practice Address - Street 1:3234 NE WASCO ST UNIT E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1981
Practice Address - Country:US
Practice Address - Phone:503-849-8119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty