Individual
TANYA L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM/PSS
Contact information
Practice address
1438 SE DIVISION ST, PORTLAND, OR 97202-1140
(971) 261-0544
(971) 245-3043
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
Primary
16-CRM-033
OR
175T00000X
Peer Specialist
THW000001319
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500730810
—
OR
Enumeration date
05/10/2016
Last updated
10/23/2025
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