Individual
TIFFANIE KEARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
(509) 229-9558
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
(509) 229-9558
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175T00000X
—
OR
Enumeration date
10/21/2015
Last updated
10/21/2015
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