Provider Demographics
NPI:1205257532
Name:MOREHEAD, ZENA THOMAS
Entity type:Individual
Prefix:MS
First Name:ZENA
Middle Name:THOMAS
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZENA
Other - Middle Name:MITCHELLE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:503-238-0769
Mailing Address - Fax:
Practice Address - Street 1:4212 SE DIVISION ST STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1680
Practice Address - Country:US
Practice Address - Phone:503-238-0705
Practice Address - Fax:503-236-7166
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health