Healthcare Provider Details

I. General information

NPI: 1548832132
Provider Name (Legal Business Name): WILLIAM KENT HALE II LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILL HALE LMFT

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 SW GREENBURG RD STE 200
TIGARD OR
97223-5502
US

IV. Provider business mailing address

9900 SW GREENBURG RD STE 200
TIGARD OR
97223-5502
US

V. Phone/Fax

Practice location:
  • Phone: 971-430-5017
  • Fax:
Mailing address:
  • Phone: 971-430-5017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT2859
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT2859
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: