Provider Demographics
NPI:1801159850
Name:INARA, TAUSHA LEE (MSW, CSWA)
Entity type:Individual
Prefix:
First Name:TAUSHA
Middle Name:LEE
Last Name:INARA
Suffix:
Gender:U
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:TAUSHA
Other - Middle Name:INARA
Other - Last Name:CUSHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:3280 NE LANCASTER ST APT 4
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4059
Mailing Address - Country:US
Mailing Address - Phone:541-757-1854
Mailing Address - Fax:
Practice Address - Street 1:182 SW ACADEMY ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1996
Practice Address - Country:US
Practice Address - Phone:503-623-9289
Practice Address - Fax:503-837-0095
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORA154241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health