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KENNETH ALLEN DOUGHERTY CRM, QMHA-I
NPI 1194234096
Peer Specialist in Tigard, OR

Active since September 22, 2017
12540 SW MAIN ST STE 202, TIGARD, OR 97223(503) 906-9995 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth Allen Dougherty Crm, Qmha-i NPPES

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

KENNETH ALLEN DOUGHERTY CRM, QMHA-I (NPI 1194234096) is an individual peer specialist in Tigard, Oregon, licensed in Oregon (25-CRM-4553) and active in the NPI registry since September 2017.

NPPES Registry Identity

NPI1194234096
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameKENNETH ALLEN DOUGHERTYCredential: CRM, QMHA-I
Location Address12540 SW MAIN ST STE 202Tigard, OR 97223-6198
Mailing Address12540 Sw Main St Ste 202Tigard, OR 97223-6198 · (503) 906-9995
Phone(503) 906-9995
Sole ProprietorYes
Enumeration DateSeptember 22, 2017
Last NPPES UpdateSeptember 30, 2025
NPPES CertifiedSeptember 30, 2025
✔ NPI 1194234096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 25-CRM-4553
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
12540 SW MAIN ST STE 202, Tigard, OR 97223
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Other Providers at the Same Location NPPES 16

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

ARYA ROERIG CADC 1
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
RECOVERY WORKS NW LLC
Clinic/Center (Multi-Specialty)
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
SARA KJESETH CRM
Peer Specialist
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
TAMMY YOUNG CRM/PSS
Peer Specialist
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (458) 262-8374
MRS. JENNIFER ROSE WITTEN NP
Nurse Practitioner (Adult Health)
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
ALEX E MAHLIOS CADC
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
PORTLAND, OR 97223
Washington County (503) 906-9995
FRANK CARTER HABECKER CADC-R
Counselor (Addiction (Substance Use Disorder))
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995
BRYAN SCHWARTZ M.D.
Internal Medicine
12540 SW MAIN ST STE 202
TIGARD, OR 97223
Washington County (503) 906-9995

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 Kenneth Dougherty's NPI number?

The NPI number for Kenneth Dougherty is 1194234096. It was assigned to this individual provider in the NPPES registry on September 22, 2017.

Where is Kenneth Dougherty located?

Kenneth Dougherty practices at 12540 SW Main St Ste 202, Tigard, OR 97223. The listed phone number is (503) 906-9995.

What is Kenneth Dougherty's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Dougherty was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.