Mr. Midian Krash Tenebrae-hickey - Portland, OR

Mr. Midian Krash Tenebrae-hickey

Peer Specialist in Portland, Oregon

NPI 1093406969

Midian Krash Tenebrae-hickey is a Peer Specialist based in Portland, OR. Midian Krash Tenebrae-hickey practices in Portland, OR. The NPI Number for Midian Krash Tenebrae-hickey is 1093406969 and holds a License No. (Oregon).

The current practice location address for Midian Krash Tenebrae-hickey is 6200 Se King Rd, Portland, OR and can be reached out via phone at 503-546-6377.

Location: 6200 Se King Rd, Portland, OR, 97222-2891

NPI Number

1093406969

Provider Name

Midian Krash Tenebrae-hickey

Credential

Provider Entity Type

Individual

Gender

Male

Address

6200 Se King Rd, Portland, OR, 97222-2891

Phone Number

503-546-6377

Fax Number

Provider Enumeration Date

05/19/2023

Last Update Date

03/10/2024

Address

6200 Se King Rd

City

Portland

State

Oregon

Zip

97222-2891

Phone Number

503-546-6377

Fax Number

Address

6200 Se King Rd

City

Portland

State

Oregon

Zip

97222-2891

Phone Number

503-546-6377

Fax Number

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

()

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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