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Individual

TARA PADDOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 632-9289
Mailing address
292 NW BONANZA AVE, DALLAS, OR 97338-1376
(503) 857-3655

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-11-07
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor

Other

Enumeration date
05/15/2014
Last updated
10/22/2024
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