Individual
HATTIE ROSE SIEGFRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM II/PSS
Contact information
Practice address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
Mailing address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21-CRM-II-0026
OR
175T00000X
Peer Specialist
THW000002635
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500746326
—
OR
Enumeration date
07/06/2018
Last updated
12/18/2023
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