Tiffany Bro
Marriage & Family Therapist in Portland, OR. Individual provider (NPI-1).
NPI number1316635865
StatusActive
Last updated in NPPESOct 17, 2024
Details
- NPI
- 1316635865
- Entity type
- Individual (NPI-1)
- Name
- Tiffany Bro
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 24, 2023
- Certification date
- Oct 17, 2024
- Last updated
- Oct 17, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | R9825 | OR | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
422 Se 79th Ave # 204Portland, OR 97215-1519
Phone 503-660-3480
Mailing address
150 Beavercreek RdOregon City, OR 97045-4302
Phone 503-655-8471
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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