Rayburn, Tara Holly

Rayburn, Tara Holly is an sole proprietor health care provider with primary practice located at 1722 Nw Raleigh St Spc 304 , Portland OR 97209-1752. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Rayburn, Tara Holly can be contacted via phone (971) 645-0148.

Contact Information

Primary practice address
1722 Nw Raleigh St Spc 304 Portland OR 97209-1752
Phone: (971) 645-0148
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 20-10-06 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 21-QMHP-R-0664 Oregon
Behavioral Health & Social Service Providers / Clinical 1041C0700X SWIA.SC.61162847 Washington
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X 15-11-08 Oregon

Profile Details

NPI number 1134584527
LBN Legal business name Rayburn, Tara Holly
Credentials CADCI
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2015
Last updated Aug 31st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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