Individual
CARRIE TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(503) 226-2203
Mailing address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
201391692RN
OR
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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