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General NPI Number Information
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NPI Number | 1598117434
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Entity Type | Individual
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Provider Name | SOMMER TIFFANY KORTH PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2016
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 18765 SW BOONES FERRY RD STE 100
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City | TUALATIN
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State | OR
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Zip | 97062-8607
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Country | US
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Telephone | 503-612-1000
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Fax | 503-612-1090
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Provider Business Mailing Address
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Address Line | 18765 SW BOONES FERRY RD STE 100
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City | TUALATIN
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State | OR
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Zip | 97062-8607
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Country | US
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Telephone | 503-612-1000
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Fax | 503-612-1090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G165850
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10047729
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5928365-4405
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 114138
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License Number State | NE
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