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Individual

TIFFANY ROSE CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QMHA-R

Contact information

Practice address
508 NW 5TH AVE., PORTLAND, OR 97209
(971) 302-9764
Mailing address
328 NW BROADWAY APT 117, PORTLAND, OR 97209-3528
(602) 361-0209

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
QMHA-R
OR
101Y00000X
Counselor
Primary

Other

Enumeration date
03/07/2024
Last updated
03/07/2024
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