Individual provider · Type 1 NPI

Kenneth Allen Dougherty, CRM, QMHA-I

Peer Specialist · Tigard, OR

NPI number 1194234096 Active

Practice location

12540 SW Main St Ste 202
Tigard, OR 97223-6198

Call (503) 906-9995 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000X25-CRM-4553 (OR)

Peer Specialist: 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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About NPI 1194234096

Kenneth Allen Dougherty, CRM, QMHA-I's National Provider Identifier is 1194234096, issued on Sep 22, 2017. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Tigard, OR. The record was last updated on Sep 30, 2025.