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General NPI Number Information
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NPI Number | 1528911716
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Entity Type | Individual
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Provider Name | CHRISTIN LEE CASEY QMHA
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Gender | Female
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 1175 E MAIN ST STE 2F
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City | MEDFORD
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State | OR
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Zip | 97504-7457
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Country | US
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Telephone | 458-225-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 E MAIN ST
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City | MEDFORD
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State | OR
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Zip | 97504-6918
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Country | US
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Telephone | 458-225-9993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 591364
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number | 591364
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 26-QMHA-R-8316
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License Number State | OR
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