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Tiffany Dawn Wolleat, CADCI/CRMII/PSS
Addiction (Substance Use Disorder) Counselor in Gresham, Oregon
NPI 1811630361

Tiffany Dawn Wolleat is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Tiffany Dawn Wolleat practices in Gresham, OR and has the professional credentials of CADCI/CRMII/PSS. The NPI Number for Tiffany Dawn Wolleat is 1811630361 and holds a License No. THW000106154 (Oregon).

The current practice location address for Tiffany Dawn Wolleat 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
1811630361
Provider Name
Tiffany Dawn Wolleat
Credential
CADCI/CRMII/PSS
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
04/13/2022
Last Update Date
04/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500806711 05 OR
500808225 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
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
24-03-11057 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000106154 (Oregon)
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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