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NPI Code Detail

MEDICARE: MS. TERRI-LYNN HEIDI MCDONALD QMHP

MEDICARE: MS. TERRI-LYNN HEIDI MCDONALD 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 : 1033265327
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERRI-LYNN HEIDI MCDONALD QMHP
Provider Business Mailing Address
First Line : 12280 SE ONE ROSA DR
Second Line :
City : HAPPY VALLEY
State : OR
Zip : 97015-7320
Country : US
Telephone Number : 925-989-1885
Fax Number :
Provider Business Practice Location Address
First Line : 5120 SE 118TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97266-3250
Country : US
Telephone Number : 503-762-3435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2007
Last Update Date : 07/08/2007

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