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TIFFANY KETTERMANN, LLC
NPI 1003461740
Counselor - Mental Health in Portland, OR

Active since August 08, 2019
2950 SE STARK ST STE 130, PORTLAND, OR 97214(971) 270-0167 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 25, 2025, Aug 8, 2019 (2 updates tracked since 2019).

About Tiffany Kettermann, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY KETTERMANN, LLC (NPI 1003461740) is a healthcare organization registered as a mental health in Portland, Oregon and active in the NPI registry since August 2019. The organization lists Tiffany Kettermann, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003461740
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameTIFFANY KETTERMANN, LLC
Location Address2950 SE STARK ST STE 130Portland, OR 97214-3082
Mailing Address2950 Se Stark St Ste 130Portland, OR 97214-3082 · (971) 270-0167
Phone(971) 270-0167
Organization SubpartNo
Authorized OfficialTiffany KettermannCeo · (971) 270-0167
Enumeration DateAugust 8, 2019
Last NPPES UpdateFebruary 25, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2025
✔ NPI 1003461740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
2950 SE STARK ST STE 130, Portland, OR 97214
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH THOMAS GIANOTTI MA
Counselor (Mental Health)
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167
DANIELLE KOLLER MSW, CSWA
Social Worker (Clinical)
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167
JUSTIN HARDMAN PSS
Peer Specialist
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167
CHARLOTTE HEESACKER CHENEY LPC ASSOCIATE
Counselor (Mental Health)
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167
IAN GROSSMAN
Case Manager/Care Coordinator
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (503) 421-8009
KAITLYN WILSON
Counselor (Mental Health)
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (559) 908-0028
KATIE STUBBERS MA
Counselor (Mental Health)
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167
SIENNA RAEN CHURCH
Counselor
2950 SE STARK ST STE 130
PORTLAND, OR 97214
Multnomah County (971) 270-0167

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Kettermann, LLC's NPI number?

The NPI number for Tiffany Kettermann, LLC is 1003461740. It was assigned to this organization in the NPPES registry on August 8, 2019.

Where is Tiffany Kettermann, LLC located?

Tiffany Kettermann, LLC is located at 2950 SE Stark St Ste 130, Portland, OR 97214. The listed phone number is (971) 270-0167.

What is Tiffany Kettermann, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does Tiffany Kettermann, LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Tiffany Kettermann, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tiffany Kettermann, LLC was last updated on February 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.