MEDICARE: KATIE LYNN MAGUIRE QMHA, CADC-R, CHW

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	171M00000X	Case Manager/Care Coordinator		OR

General Provider Information

NPI Number	:	1326791427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE LYNN MAGUIRE QMHA, CADC-R, CHW

Provider Business Mailing Address
First Line	:	65 N HIGHWAY 101 STE 204
Second Line	:
City	:	WARRENTON
State	:	OR
Zip	:	97146-9371
Country	:	US
Telephone Number	:	503-325-5722
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 W MARINE DRIVE
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103
Country	:	US
Telephone Number	:	503-325-5722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	02/11/2026

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