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Madelynn R Tice, QMHA-I
Mental Health Counselor in Gresham, Oregon
NPI 1285233460

Madelynn R Tice is a Mental Health Counselor based in Portland, OR and is specialized in Mental Health. Madelynn R Tice practices in Gresham, OR and has the professional credentials of QMHA-I. The NPI Number for Madelynn R Tice is 1285233460 and holds a License No. 20-QMHA-R-0816 (Oregon).

The current practice location address for Madelynn R Tice is 620 Ne 2Nd St, Gresham, OR and can be reached out via phone at 971-274-3757 and via fax at 503-912-5740.

Location: 620 Ne 2Nd St, Gresham, OR, 97205-1715
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285233460
Provider Name
Madelynn R Tice
Credential
QMHA-I
Provider Entity Type
Individual
Gender
Female
Address
620 Ne 2Nd St, Gresham, OR, 97205-1715
Phone Number
971-274-3757
Fax Number
503-912-5740
Provider Enumeration Date
10/20/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500785589 05 OR
institution
Provider Business Practice Location Address Details
Address
620 Ne 2Nd St
City
Gresham
State
Oregon
Zip
97030-7514
Phone Number
971-274-3757
Fax Number
503-912-5740
person
Provider Business Mailing Address Details
Address
620 Ne 2Nd St
City
Gresham
State
Oregon
Zip
97030-7514
Phone Number
971-274-3757
Fax Number
503-912-5740
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
20-QMHA-R-0816 (Oregon)
Definition
Definition to come...
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