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NPI Code Detail

MEDICARE: JOSE RICARDO VARGAS GARCIA MA

MEDICARE: JOSE RICARDO VARGAS GARCIA MA
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
1171M00000XCase Manager/Care CoordinatorOR
2101YM0800XMental Health CounselorOR
3101YA0400XAddiction (Substance Use Disorder) CounselorOR

General Provider Information

NPI Number : 1205116092
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE RICARDO VARGAS GARCIA MA
Provider Business Mailing Address
First Line : 627 NE EVANS ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-3923
Country : US
Telephone Number : 503-434-7523
Fax Number :
Provider Business Practice Location Address
First Line : 627 NE EVANS ST
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-3923
Country : US
Telephone Number : 503-434-7523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2011
Last Update Date : 12/03/2025

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Directions to “ JOSE RICARDO VARGAS GARCIA MA” Practice Location

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