Individual
TIERNEY HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, MA
Contact information
Practice address
4531 SE BELMONT ST STE 102, PORTLAND, OR 97215-1675
(503) 334-2533
Mailing address
PO BOX 33644, PORTLAND, OR 97292-3644
(503) 334-2533
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61200403
WA
106H00000X
Marriage & Family Therapist
Primary
R7822
OR
Other
Enumeration date
09/29/2021
Last updated
12/09/2022
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