Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Tate Allen Waggoner, QMHP-C

Individual provider Mental Health Counselor · NPI 1356058978

Mr. Tate Allen Waggoner, QMHP-C is a Mental Health Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2022.

Licensed in
OR
In the registry since
2022

Practice location Address checks out

1631 SW Columbia St
Portland, OR 97201-6025
Phone: (503) 231-2641
Fax: (503) 467-4077
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 25-QMHP-C-001612 (OR)

Record details

NPI number1356058978
Entity typeIndividual (Type 1)
GenderMale
Credentials QMHP-C
Sole proprietorNo
NPI enumeratedNovember 2, 2022
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025

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