Individual
CORY DEAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM-PSS
Contact information
Practice address
900 MAIN ST STE 200, OREGON CITY, OR 97045-1869
(971) 256-4194
Mailing address
PO BOX 16756, PORTLAND, OR 97292-0756
(503) 753-5162
(503) 208-2596
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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