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TARA LEE FETTERLY QMHA
NPI 1790222487
Peer Specialist in Prineville, OR

Active since January 19, 2017
1251 NE ELM ST, PRINEVILLE, OR 97754(541) 323-5330(541) 447-4418 Get Directions Write a Review

NPPES record last updated: January 19, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tara Lee Fetterly Qmha NPPES

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

TARA LEE FETTERLY QMHA (NPI 1790222487) is an individual peer specialist in Prineville, Oregon and active in the NPI registry since January 2017.

NPPES Registry Identity

NPI1790222487
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameTARA LEE FETTERLYCredential: QMHA
Location Address1251 NE ELM STPrineville, OR 97754-1206
Mailing Address1251 Ne Elm StPrineville, OR 97754-1206 · (541) 323-5330 · Fax (541) 447-4418
Phone(541) 323-5330
Fax(541) 447-4418
Sole ProprietorNo
Enumeration DateJanuary 19, 2017
✔ NPI 1790222487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
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.
1251 NE ELM ST, Prineville, OR 97754
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Other Identifiers 1

Medicaid283234OR

Other Providers at the Same Location NPPES 19

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

ANDREA TAVARES CUNHA MA
Counselor (Mental Health)
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 323-5330
MR. KENNETH W SMITH P.T.
Physical Therapist
1251 NE ELM ST, STE 2-A
PRINEVILLE, OR 97754
Crook County (541) 447-6846
CYNTHIA STIDD LCSW
Social Worker (Clinical)
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 323-5330
KATIE MORRISON
Counselor (Mental Health)
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 323-5330
KARIANNE CLARK
Social Worker
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 323-5330
LABORATORY CORPORATION OF AMERICA
Clinical Medical Laboratory
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (800) 598-3345
ROENTGEN SERVICES, LLC
Technician, Other
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 447-1008
MRS. COURTNEY ANNE PARCHMON LPC, CADCI
Counselor (Mental Health)
1251 NE ELM ST
PRINEVILLE, OR 97754
Crook County (541) 323-5330

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 Tara Fetterly's NPI number?

The NPI number for Tara Fetterly is 1790222487. It was assigned to this individual provider in the NPPES registry on January 19, 2017.

Where is Tara Fetterly located?

Tara Fetterly practices at 1251 NE Elm St, Prineville, OR 97754. The listed phone number is (541) 323-5330.

What is Tara Fetterly'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 Tara Fetterly was last updated on January 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.