Individual
TONYA D. KRAKE-BETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
12636 SE STARK ST, PORTLAND, OR 97233-1058
(503) 853-4600
(503) 859-4609
Mailing address
12636 SE STARK ST, PORTLAND, OR 97233-1058
(503) 253-4600
(503) 253-4609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3042
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
10/19/2006
Last updated
09/23/2013
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