Individual
MRS. TANIS VAIL HAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(971) 300-1815
Mailing address
2600 SE BELMONT, PORTLAND, OR 97214
(971) 300-1815
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/08/2017
Last updated
05/08/2017
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