Provider Demographics
NPI:1740084102
Name:WHITTEN, TAYLOR (CSWA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:WHITTEN
Suffix:
Gender:
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65348 GURDANE RD
Mailing Address - Street 2:
Mailing Address - City:PILOT ROCK
Mailing Address - State:OR
Mailing Address - Zip Code:97868-6606
Mailing Address - Country:US
Mailing Address - Phone:541-377-6677
Mailing Address - Fax:
Practice Address - Street 1:1100 SOUTHGATE STE 3
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3971
Practice Address - Country:US
Practice Address - Phone:541-215-4440
Practice Address - Fax:541-429-4118
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA154831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical