DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MICHAEL RICHARD BROCK QMHA

MEDICARE: MICHAEL RICHARD BROCK 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
1171M00000XCase Manager/Care Coordinator
2372600000XAdult Companion

General Provider Information

NPI Number : 1558415091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RICHARD BROCK QMHA
Provider Business Mailing Address
First Line : 11716 NE 49TH ST APT S2
Second Line :
City : VANCOUVER
State : WA
Zip : 98682-6171
Country : US
Telephone Number : 360-609-2639
Fax Number :
Provider Business Practice Location Address
First Line : 310 NW FLANDERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97209-3941
Country : US
Telephone Number : 503-827-3949
Fax Number : 503-827-0931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 09/11/2025

Similar Medicare Providers

1902951320 — MR. SEAN SCOTT CARTER QMHA
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931
1962589259 — CASCADIA HEALTH
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931
1679627111 — ELVA WOLF REDWOOD QMHA
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931
1821143199 — MR. ERIC PASCAL SEVOS LCSW, QMHP
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931
1861547275 — DEIRDRE KATHLEEN BENTLEY QMHP
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931
1700931110 — DAWN MICHELLE COLEMAN QMHA
Practice Location Address:
310 NW FLANDERS ST
PORTLAND, OR
97209-3941
Practice Phone: 503-827-3949
Practice Fax: 503-827-0931

Directions to “ MICHAEL RICHARD BROCK 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.