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Organization

HEALTH ALLIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY KETTERMANN LPC, LMHC, CADCI (PRESIDENT)
(971) 270-0167
Entity
Organization

Contact information

Practice address
2926 NE FLANDERS ST STE 3C, PORTLAND, OR 97232-3259
(971) 270-0167
Mailing address
2926 NE FLANDERS ST STE 3C, PORTLAND, OR 97232-3259
(971) 270-0167

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251K00000X
Public Health or Welfare Agency
251V00000X
Voluntary or Charitable Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
08/08/2019
Last updated
08/08/2019
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