MEDICARE: MR. DAVID KENNETH HIRES B.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C9415	OR

General Provider Information

NPI Number	:	1538551866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID KENNETH HIRES B.A.

Provider Business Mailing Address
First Line	:	6975 SW SANDBURG ST STE 250
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8088
Country	:	US
Telephone Number	:	503-455-4423
Fax Number	:

Provider Business Practice Location Address
First Line	:	6975 SW SANDBURG ST STE 250
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-8088
Country	:	US
Telephone Number	:	503-455-4423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	05/28/2026

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