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NPI Code Detail

MEDICARE: DR. NEVILLE CORDELL QMHP, MD

MEDICARE:  DR. NEVILLE  CORDELL  QMHP, MD
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 : 1205047115
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NEVILLE CORDELL QMHP, MD
Provider Business Mailing Address
First Line : 1975 MCPHERSON ST
Second Line : SUITE 2
City : NORTH BEND
State : OR
Zip : 97459-3482
Country : US
Telephone Number : 541-756-2020
Fax Number : 541-756-8982
Provider Business Practice Location Address
First Line : 1975 MCPHERSON ST
Second Line : SUITE 2
City : NORTH BEND
State : OR
Zip : 97459-3482
Country : US
Telephone Number : 541-756-2020
Fax Number : 541-756-8982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 05/24/2026

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Directions to “ DR. NEVILLE CORDELL QMHP, MD” Practice Location

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