Individual
BRYAN JOSEPH TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR INTERN
Contact information
Practice address
6950 SW HAMPTON ST STE 310, TIGARD, OR 97223-8332
(971) 200-5196
Mailing address
6950 SW HAMPTON ST STE 310, TIGARD, OR 97223-8332
(971) 200-5196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
146N00000X
Basic Emergency Medical Technician
Primary
E098624
CA
Other
Enumeration date
04/28/2017
Last updated
07/16/2026
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