Individual
KRISTEN KAY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LMHC, CADC II
Contact information
Practice address
5125 SKYLINE RD S, SALEM, OR 97306-9427
(503) 813-2000
Mailing address
5125 SKYLINE RD S, SALEM, OR 97306-9413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
101YP2500X
Professional Counselor
Primary
C4050
OR
Other
Enumeration date
02/02/2012
Last updated
09/06/2022
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