Provider Demographics
NPI:1821887803
Name:WHITMARSH, EMMA HAILEY (CHW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:HAILEY
Last Name:WHITMARSH
Suffix:
Gender:
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E RAPP RD APT D
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-5603
Mailing Address - Country:US
Mailing Address - Phone:916-220-9990
Mailing Address - Fax:
Practice Address - Street 1:534 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7118
Practice Address - Country:US
Practice Address - Phone:541-499-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR113852172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker