Individual
TIFFANY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 SW FRAZER AVE STE 282, PENDLETON, OR 97801-0048
(541) 278-6330
(541) 278-5419
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/29/2016
Last updated
05/21/2020
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