Individual
TATIANA FENELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 SE INTERNATIONAL WAY STE 500, MILWAUKIE, OR 97222-8855
(503) 258-4545
Mailing address
4105 SE INTERNATIONAL WAY STE 500, MILWAUKIE, OR 97222-8855
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
26-QMHA-R-8354
OR
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
02/26/2026
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