Individual
TARA R VANDEHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II/QMHP
Contact information
Practice address
1030 NE COUCH ST, PORTLAND, OR 97232-3067
(503) 239-8400
(503) 239-8407
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-04-77
OR
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500640364
—
OR
05
—
500725404
—
OR
Enumeration date
04/02/2007
Last updated
09/05/2019
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