Provider Demographics
NPI:1578044608
Name:TIFFANY C. DEL POZO
Entity Type:Organization
Organization Name:TIFFANY C. DEL POZO
Other - Org Name:TIFFANY C. DEL POZO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:DEL POZO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:971-250-1615
Mailing Address - Street 1:20370 SW NAVARRE LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-4269
Mailing Address - Country:US
Mailing Address - Phone:971-250-1615
Mailing Address - Fax:
Practice Address - Street 1:11950 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-8923
Practice Address - Country:US
Practice Address - Phone:971-250-1615
Practice Address - Fax:503-214-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty