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NPI Code Detail

MEDICARE: ELIZABETH JEAN FOX QMHA

MEDICARE:   ELIZABETH JEAN FOX  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 : 1023162641
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JEAN FOX QMHA
Provider Business Mailing Address
First Line : 2025 NE DEKUM ST
Second Line :
City : PORTLAND
State : OR
Zip : 97211-5314
Country : US
Telephone Number : 503-285-2530
Fax Number :
Provider Business Practice Location Address
First Line : 7621 N PORTSMOUTH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-5953
Country : US
Telephone Number : 503-285-2530
Fax Number : 503-240-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 09/11/2025

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Directions to “ ELIZABETH JEAN FOX QMHA” Practice Location

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