Provider Demographics
NPI:1588229959
Name:BARETICH, KIERRA (LLMSW)
Entity Type:Individual
Prefix:
First Name:KIERRA
Middle Name:
Last Name:BARETICH
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:KIERRA
Other - Middle Name:
Other - Last Name:ROWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37422 COHO ST
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-6884
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7110 SW FIR LOOP STE 151
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8031
Practice Address - Country:US
Practice Address - Phone:503-563-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical