Individual provider · Type 1 NPI

Tiffany D. Wolleat, CADCI/CRMII/PSS/QMHA

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1811630361 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Fax (503) 912-5740

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X25-QMHA-R-6749 (OR)
Peer Specialist 175T00000XTHW000106154 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X24-03-11057 (OR)
Addiction (Substance Use Disorder) Counselor 101YA0400X24-CRM-II-0221 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1811630361

Tiffany D. Wolleat, CADCI/CRMII/PSS/QMHA's National Provider Identifier is 1811630361, issued on Apr 13, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Jun 30, 2025.