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NPI Code Detail

MEDICARE: BRANDY GERKEN QMHA

MEDICARE: BRANDY GERKEN QMHA
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 Counselor25-QMHA-R-7016OR

General Provider Information

NPI Number : 1588455794
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY GERKEN QMHA
Provider Business Mailing Address
First Line : 211 SE CARUTHERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4502
Country : US
Telephone Number : 503-224-1044
Fax Number : 971-260-0355
Provider Business Practice Location Address
First Line : 1631 SW COLUMBIA ST
Second Line :
City : PORTLAND
State : OR
Zip : 97201-6025
Country : US
Telephone Number : 503-231-2641
Fax Number : 503-231-1654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2025
Last Update Date : 03/19/2026

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