Mr. Tate Allen Waggoner is a Portland, Oregon based counselor who is specialized as Mental Health Counselor. Active license number of Mr. Tate Allen Waggoner is 25-QMHP-C-001612 for Mental Health Counselor in Oregon. His current practice location is 1631 Sw Columbia St, Portland. Patients can book an appointment with him at 503-231-2641.
Mr. Tate Allen Waggoner is a licensed professional who helps individuals, couples, and families manage and overcome emotional, psychological, and behavioral challenges. He assess clients’ mental health conditions and develop personalized treatment plans to provide therapy for a range of mental health issues, including anxiety, depression, trauma, relationship issues, stress, grief, and life transitions.
Complete Profile:
Mr. Tate Allen Waggoner speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Mr. Tate Allen Waggoner
Specialization:
Mental Health Counselor
Gender:
Male
Credentials:
QMHP-C
Accepts Medicare Assignment:
No
Practice Address:
1631 Sw Columbia St, Portland, Oregon, 97201-6025
Phone:
503-231-2641
Fax:
503-467-4077
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1356058978
NPI Enumeration Date:
02 Nov, 2022
NPI Last Update On:
06 Mar, 2025
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Tate Allen Waggoner are as mentioned below.
License Number
Specialization
State
Status
25-QMHP-C-001612
Mental Health Counselor
Oregon
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Tate Allen Waggoner such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
500814541
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
211 Se Caruthers St, Portland, Oregon
Zip:
97214-4502
Phone Number:
503-224-1044
Fax Number:
971-260-0355
Patients can reach Mr. Tate Allen Waggoner at 1631 Sw Columbia St, Portland, Oregon or can call to book an appointment on 503-231-2641. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 July, 2025.