Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TARA HOLLY RAYBURN, CADCI
Active Sole ProprietorAddiction (Substance Use Disorder) Psychologist · PORTLAND, OR
Registration Details
- NPI Number
- 1134584527
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 29, 2015 (10.354960185971 yrs)
- Last Updated
- Aug 31, 2021
- Licenses
-
20-10-06 (OR)21-QMHP-R-0664 (OR)SWIA.SC.61162847 (WA)15-11-08 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1722 NW RALEIGH ST SPC 304PORTLAND, OR, 972091752Browse OR providers · Browse ZIP 97209
- Phone
- 9716450148
- Primary Specialty
-
Addiction (Substance Use Disorder) Psychologist
103TA0400X
- Additional Specialty
- Mental Health Counselor
- Additional Specialty
- Clinical Social Worker
- Additional Specialty
- Addiction (Substance Use Disorder) Psychologist
Other Addiction (Substance Use Disorder) Psychologist Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| DR. ANTHONY NELLO GIARDINA | PSY D | 1811338056 |
| MS. WALINDA RENE WEEKLY | MSW | 1366188237 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.