Organization
CRC ALLIED HEALTH
Active
Organization
CRC ALLIED HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE TIERNY BS CADC II (CLINICAL DIRECTOR)
(503) 226-2203
Entity
Organization
Contact information
Practice address
808 SW ALDER ST, STE #300, PORTLAND, OR 97205-3133
(503) 226-2203
(503) 223-4231
Mailing address
808 SW ALDER ST, STE #300, PORTLAND, OR 97205-3133
(503) 226-2203
(503) 223-4231
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
130906
OR
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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