Individual
SOMMER TIFFANY KORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
(503) 612-1090
Mailing address
18765 SW BOONES FERRY RD STE 100, TUALATIN, OR 97062-8607
(503) 612-1000
(503) 612-1090
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5928365-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10047729
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
114138
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
G165850
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114138
STATE OF NEBRASKA DEPT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH
NE
01
—
A165752
IOWA BOARD OF NURSING
IA
01
—
CP002103
SOUTH DAKOTA BOARD OF NURSING
SD
01
—
G165850
IOWA BOARD OF NURSING
IA
Enumeration date
07/03/2016
Last updated
10/02/2025
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