Individual
TIM LUDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, MA
Contact information
Practice address
8305 SE MONTEREY AVE, SUITE 220, HAPPY VALLEY, OR 97086-7725
(503) 701-8839
Mailing address
8305 SE MONTEREY AVE, SUITE 220, HAPPY VALLEY, OR 97086-7725
(503) 701-8839
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C2972
OR
101YM0800X
Mental Health Counselor
C2972
OR
101YP2500X
Professional Counselor
Primary
C2972
OR
Other
Enumeration date
02/08/2011
Last updated
09/13/2012
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