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NPI Code Detail

MEDICARE: ALLISON MARIE FRASER QMHP

MEDICARE: ALLISON MARIE FRASER QMHP
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1235204165
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON MARIE FRASER QMHP
Provider Business Mailing Address
First Line : 15603 NE 1ST CIRCLE
Second Line :
City : VANCOUVER
State : WA
Zip : 98684
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NE SISKIYOU ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-2471
Country : US
Telephone Number : 503-528-0757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 07/08/2007

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