Healthcare Provider Details

I. General information

NPI: 1760588461
Provider Name (Legal Business Name): ALAINA RUTH ZIPP LCSW, CADC,QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 NE 102ND AVE
PORTLAND OR
97220-4167
US

IV. Provider business mailing address

6626 NE HANCOCK CT # 145
PORTLAND OR
97213-4875
US

V. Phone/Fax

Practice location:
  • Phone: 503-253-6754
  • Fax: 503-253-8020
Mailing address:
  • Phone: 503-256-6327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL2151
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: