1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Counselor
  6. NPI Profile

MR. TATE ALLEN WAGGONER QMHP-C
NPI 1356058978
Counselor - Mental Health in Portland, OR

Active since November 02, 2022
1631 SW COLUMBIA ST, PORTLAND, OR 97201(503) 231-2641(503) 467-4077 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2025, Mar 23, 2023, Nov 2, 2022 (3 updates tracked since 2022).

About Mr. Tate Allen Waggoner Qmhp-c NPPES

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

MR. TATE ALLEN WAGGONER QMHP-C (NPI 1356058978) is an individual mental health provider in Portland, Oregon, licensed in Oregon (25-QMHP-C-001612) and active in the NPI registry since November 2022.

NPPES Registry Identity

NPI1356058978
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. TATE ALLEN WAGGONERCredential: QMHP-C
Location Address1631 SW COLUMBIA STPortland, OR 97201-6025
Mailing Address211 Se Caruthers StPortland, OR 97214-4502 · (503) 224-1044 · Fax (971) 260-0355
Phone(503) 231-2641
Fax(503) 467-4077
Sole ProprietorNo
Enumeration DateNovember 2, 2022
Last NPPES UpdateMarch 6, 20253 updates tracked since enumeration
NPPES CertifiedMarch 6, 2025
✔ NPI 1356058978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · 25-QMHP-C-001612
1631 SW COLUMBIA ST, Portland, OR 97201
Open in Google Maps ↗

Other Identifiers 1

Medicaid500814541OR

Other Providers at the Same Location NPPES 20

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

AMBER C LEWIS CRM/PSS
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
JESSICA L SPAIN CADC I/QMHA-R
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
NICOLE MARIE WILLIAMS CADC II/QMHA-I
Counselor (Mental Health)
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
ANDULIA WHITE ELK CADCI
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
MIKE W BROCKMAN CADC II/QMHA-I
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
OULU MARIE NOONAN CADC-R
Rehabilitation Practitioner
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
PEGGY LACOMBE CADCII
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
NAIMAH JOHNSON QMHA-I
Counselor (Mental Health)
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641

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 Tate Waggoner's NPI number?

The NPI number for Tate Waggoner is 1356058978. It was assigned to this individual provider in the NPPES registry on November 2, 2022.

Where is Tate Waggoner located?

Tate Waggoner practices at 1631 SW Columbia St, Portland, OR 97201. The listed phone number is (503) 231-2641.

What is Tate Waggoner's specialty?

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

When was this NPI record last updated?

The NPPES record for Tate Waggoner was last updated on March 6, 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.