TATE ALLEN WAGGONER

PORTLAND, OR
NPI1356058978
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OR  25-QMHP-C-001612)
Enumeration Date2022-11-02
Last Update Date2025-03-06
Business Address
Mr. TATE ALLEN WAGGONER QMHP-C
1631 SW COLUMBIA ST
PORTLAND, OR 97201-6025
Phone number: 503-231-2641
Mailing Address
Mr. TATE ALLEN WAGGONER QMHP-C
211 SE CARUTHERS ST
PORTLAND, OR 97214-4502
Phone number: 503-224-1044
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