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Tye Dewald
Peer Specialist in Milwaukie, Oregon
NPI 1982175378

Tye Dewald is a Peer Specialist based in Aurora, OR. Tye Dewald practices in Milwaukie, OR. The NPI Number for Tye Dewald is 1982175378 and holds a License No. (Oregon).

The current practice location address for Tye Dewald is 11073 Se Main St, Milwaukie, OR and can be reached out via phone at 503-592-3204. You can also correspond with Tye Dewald through the mailing address at 21356 HUBBARD CUTOFF RD NE UNIT 9, AURORA, OR - 97002-8401 (mailing address contact number: 503-592-3204).

Location: 11073 Se Main St, Milwaukie, OR, 97002-8401
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982175378
Provider Name
Tye Dewald
Credential
Provider Entity Type
Individual
Gender
Male
Address
11073 Se Main St, Milwaukie, OR, 97002-8401
Phone Number
503-592-3204
Fax Number
Provider Enumeration Date
12/10/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11073 Se Main St
City
Milwaukie
State
Oregon
Zip
97222-7645
Phone Number
503-592-3204
Fax Number
person
Provider Business Mailing Address Details
Address
11073 Se Main St
City
Milwaukie
State
Oregon
Zip
97222-7645
Phone Number
503-592-3204
Fax Number
person
Provider's Taxonomy Details 1
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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