MEDICARE: JESSICA MCFARLAND 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1669832374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MCFARLAND QMHA

Provider Business Mailing Address
First Line	:	3876 BEVERLY AVE NE # G
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97305-1319
Country	:	US
Telephone Number	:	503-373-0344
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 25TH AVE NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-0338
Country	:	US
Telephone Number	:	503-373-0344
Fax Number	:

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

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	02/24/2016

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