TIFFANY DAWN WOLLEAT CADC I/CRM II/PSS NPI 1811630361

NPI Information

  • NPI: 1811630361
  • Provider Name: TIFFANY DAWN WOLLEAT, CADC I/CRM II/PSS
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 620 NE 2ND ST
    GRESHAM, OR
    ZIP 97030
  • Phone: (971) 274-3757

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NPI Details

Tiffany Dawn Wolleat, CADC I/CRM II/PSS is an addiction (substance use disorder) counselor in Gresham, OR. Tiffany Dawn Wolleat, CADC I/CRM II/PSS NPI is 1811630361. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

620 NE 2ND ST
GRESHAM, OR
ZIP 97030-514
Phone: (971) 274-3757
Fax: (503) 912-5740

The enumeration date for this NPI number is 4/13/2022 and was last updated on 3/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175T00000XPeer SpecialistTHW000106154OREGONNo
2101YA0400XCounselorAddiction (Substance Use Disorder)24-03-11057OREGONYes
3101YA0400XCounselorAddiction (Substance Use Disorder)24-CRM-II-0221OREGONNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500806711MEDICAIDOREGON
2500808225MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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