Individual
TARA ANN LAWHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM/PWS/QMHA-R
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(503) 548-0346
(503) 232-5959
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
23-CRM-2068
OR
101YM0800X
Mental Health Counselor
25-QMHA-R-7021
OR
175T00000X
Peer Specialist
Primary
109388
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500841484
—
OR
Enumeration date
12/07/2023
Last updated
06/03/2025
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