Tilden McDonald Jr., CRM/PSS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

20-CRM-067 Issued in OR

Practice address

355 NW Division St
Gresham, OR 97030-5523

Phone

(971) 225-6695

Fax

(503) 231-1654

NPI assigned

Nov 16, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1821691668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305523",
            "telephone_number": "971-225-6695",
            "fax_number": "503-231-1654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1631 SW Columbia St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972016025",
            "country_code": "US",
            "telephone_number": "503-231-2641",
            "fax_number": "503-231-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TILDEN",
        "name_suffix": "Jr.",
        "credential": "CRM/PSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000004376",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "20-CRM-067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500787753",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Elizabeth McCoy, OTR/L OTD
• McCrae Management & Investments, LTD.
• Bryhanna Christinecharles McCully, PAC
• Cheryl Renee McDaniel, RDH
• Dietrich Lamont McDaniel, CADCII/CRM/PSS/QMHAI
• Courtney McEldowney, L.M.T
• Dani McFarland
• Ann McFarlane
• Annette McGahey, LMT
• Alex McGee, LMT

• Addiction (Substance Use Disorder) Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.