Healthcare Provider Details

I. General information

NPI: 1477480416
Provider Name (Legal Business Name): CHERIE HADLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 NW 12TH ST
GRESHAM OR
97030-5568
US

IV. Provider business mailing address

2113 NW 12TH ST
GRESHAM OR
97030-5568
US

V. Phone/Fax

Practice location:
  • Phone: 150-396-0919
  • Fax:
Mailing address:
  • Phone: 150-396-0919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: