Provider Demographics
NPI:1770033474
Name:SERAFINI, WHITNEY A (PNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:A
Last Name:SERAFINI
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:541-732-8360
Mailing Address - Fax:
Practice Address - Street 1:840 ROYAL AVE
Practice Address - Street 2:STE 110
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6461
Practice Address - Country:US
Practice Address - Phone:541-732-8360
Practice Address - Fax:541-732-8361
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201606186NP-PP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics