MEDICARE: SHELLY R CARLSON QMHA

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1174146948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY R CARLSON QMHA

Provider Business Mailing Address
First Line	:	3723 FAIRVIEW INDUSTRIAL DR SE STE 170
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-1174
Country	:	US
Telephone Number	:	503-371-1970
Fax Number	:	503-371-0192

Provider Business Practice Location Address
First Line	:	3723 FAIRVIEW INDUSTRIAL DR SE STE 170
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-1174
Country	:	US
Telephone Number	:	503-371-1970
Fax Number	:	503-371-0192

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

Provider Enumeration Date	:	05/27/2020
Last Update Date	:	05/27/2020

Similar Medicare Providers

1275795619 — COACTION, INC.
Practice Location Address:

3723 FAIRVIEW INDUSTRIAL DR SE STE 170
SALEM, OR
97302-1174

Practice Phone: 503-371-1970
Practice Fax: 503-371-0192

1972131001 — VICTORIA R PADRON RD, LD, CD
Practice Location Address:

3723 FAIRVIEW INDUSTRIAL DR SE STE 170
SALEM, OR
97302-1174

Practice Phone: 503-371-1970
Practice Fax:

1275574113 — KATHRYN L LUEKEN M.D.
Practice Location Address:

1174 CORNUCOPIA ST NW STE 120
SALEM, OR
97304-3193

Practice Phone: 503-399-2424
Practice Fax: 503-375-7429

1013944016 — DR. BENTON JOHN DAVIDSON MD
Practice Location Address:

1174 CORNUCOPIA ST NW , SUITE 240
SALEM, OR
97304-3193

Practice Phone: 503-385-1664
Practice Fax: 503-991-5768

1962781526 — SALEM CLINIC, PC
Practice Location Address:

1174 CORNUCOPIA ST NW STE 120
SALEM, OR
97304-3193

Practice Phone: 503-399-2424
Practice Fax: 503-375-7429

1043577075 — LINDSIE JONES
Practice Location Address:

1174 CORNUCOPIA ST NW STE 110
SALEM, OR
97304-3193

Practice Phone: 541-714-3042
Practice Fax:

Directions to “ SHELLY R CARLSON QMHA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.