Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1841809134 Individual Practitioner Female Practitioner

Nicole Grace Whiskeyjack , CRM

Prevention Professional • Pendleton, OR

Professional Overview & Biography Verified Profile Summary

Nicole Whiskeyjack, CRM is a registered healthcare professional specializing in Prevention Professional in Pendleton, OR. Practice services are available at 46314 TIMINE WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

46314 Timine Way

Pendleton, OR 978019417

Telephone 5412408740
Fax 5412408754
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Prevention Professional in Pendleton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
13 Specialists

Practicing in Pendleton, OR (24 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-01-20
Prevention Professional Primary Specialty

NUCC Taxonomy Code: 405300000X

State License OR 20-CRM-173

Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Sharon Boothe , CADC I

Counselor - Addiction (Substance Use Disorder)

NPI 1043967573

CADCI

Mercedes Vantassel , BS, QMHA, CADC II

Counselor - Addiction (Substance Use Disorder)

NPI 1164754073

Bachelor of Science, QMHA, CADCII

Vivian Shaw , CRM

Prevention Professional

NPI 1205446663
James Rinehart , CADCLL

Counselor - Addiction (Substance Use Disorder)

NPI 1295205383
Andrew Laffie , CSWA

Counselor - Mental Health

NPI 1376166876
Kelsey Burns

Peer Specialist

NPI 1487302337

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 23, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2020

Registered at 46314 TIMINE WAY, PENDLETON, OR 978019417 (Tel: 5412408740)

📍
Updated Business Mailing Address July 23, 2020

Registered at PO BOX 160, PENDLETON, OR 978010160 (Tel: 5419669830)

👤
Provider Name / Credentials Updated July 23, 2020

Recorded as NICOLE WHISKEYJACK, CRM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2020

Prevention Professional (License #20-CRM-173 in OR)

🟢
Initial NPI Registration & Enumeration July 23, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1841809134
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 23, 2020
Last Update: January 20, 2023
Sole Proprietor: No

Mailing Address

Po Box 160

Pendleton, OR 978010160

Phone: 5419669830

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.