Provider Demographics
NPI:1639962541
Name:WHITE, LAWRENCE (QMHP)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 DOGWOOD DR S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4070
Mailing Address - Country:US
Mailing Address - Phone:253-312-0950
Mailing Address - Fax:
Practice Address - Street 1:565 UNION ST NE STE 205
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2418
Practice Address - Country:US
Practice Address - Phone:503-877-3778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program