Healthcare Provider Details

I. General information

NPI: 1114207909
Provider Name (Legal Business Name): HALEY MARIE ATHERTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 SE BASELINE
HILLSBORO OR
97124-4103
US

IV. Provider business mailing address

14194 SW BARROWS RD UNIT 3
TIGARD OR
97223
US

V. Phone/Fax

Practice location:
  • Phone: 503-640-4222
  • Fax: 503-640-0334
Mailing address:
  • Phone: 575-640-2119
  • Fax: 503-640-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: