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1144250168

NPI Code Detail

MEDICARE: PROJECT QUEST

MEDICARE: PROJECT QUEST

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	087006211N6	OR
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	964	OR
3	103TC1900X	Counseling Psychologist	1690	OR
4	103TC1900X	Counseling Psychologist	964	OR
5	171100000X	Acupuncturist	AC00106	OR
6	175F00000X	Naturopath	0896	OR
7	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	DO19964	OR
8	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144250168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROJECT QUEST

Provider Business Mailing Address
First Line	:	PO BOX 86160
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97286-0160
Country	:	US
Telephone Number	:	503-238-5203
Fax Number	:	503-238-5202

Provider Business Practice Location Address
First Line	:	3231 SE 50TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-2248
Country	:	US
Telephone Number	:	503-238-5203
Fax Number	:	503-238-5202

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	LEELA JACKIE LONGSON
Credential	:
Telephone Number	:	503-238-5203

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/02/2023

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Directions to “PROJECT QUEST ” 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.

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