Individual ProviderTyanna BensonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address16100 NW Cornell Rd # 220, Beaverton, OR 97006-7334(503) 878-8885(503) 523-0296PECOS EnrollmentBased on the most recent information from CMS, provider Tyanna Benson is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1467762302Provider TypeIndividualFull NameBenson, TyannaCredentialQMHP, LSWAIC, MSWGenderFemaleSole ProprietorNoEnumeration Date10/13/2010Last Updated8/15/2023Contact InformationPractice LocationPractice Address16100 NW Cornell Rd # 220, Beaverton, OR 97006-7334Phone(503) 878-8885Fax(971) 297-1360Mailing LocationMailing Address65 SW Yamhill St Ste 300, Portland, OR 97204-3316Phone(503) 523-0296Fax(503) 523-0296Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense61323470WashingtonCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer