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NPI Code Detail

MEDICARE: HANNAH JAQUISS

MEDICARE:   HANNAH  JAQUISS
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

General Provider Information

NPI Number : 1578413175
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH JAQUISS
Provider Business Mailing Address
First Line : PO BOX 8459
Second Line :
City : PORTLAND
State : OR
Zip : 97207-8459
Country : US
Telephone Number : 503-238-0769
Fax Number :
Provider Business Practice Location Address
First Line : 7405 SE 84TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97266-5840
Country : US
Telephone Number : 503-771-1645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ HANNAH JAQUISS ” Practice Location

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