Individual
SAMUEL ALLEN TUCKWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R/CSWA
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-24-3972
OR
104100000X
Social Worker
Primary
A14705
OR
104100000X
Social Worker
SC61570839
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500819391
—
OR
Enumeration date
05/02/2023
Last updated
06/10/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us