Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kenneth Allen Dougherty, CRM, QMHA-I

Individual provider Peer Specialist · NPI 1194234096

Kenneth Allen Dougherty, CRM, QMHA-I is a Peer Specialist in Tigard, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2017
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Practice location Address checks out

12540 SW Main St Ste 202
Tigard, OR 97223-6198
Phone: (503) 906-9995
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 25-CRM-4553 (OR)

Record details

NPI number1194234096
Entity typeIndividual (Type 1)
GenderMale
Credentials CRM , QMHA-I
Sole proprietorYes
NPI enumeratedSeptember 22, 2017
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 30, 2025

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