MEDICARE: ERICA LYNN GELDER TUCKER FLORES QMHA 1, MSW INTERN

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	104100000X	Social Worker		OR

General Provider Information

NPI Number	:	1912858416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LYNN GELDER TUCKER FLORES QMHA 1, MSW INTERN

Provider Business Mailing Address
First Line	:	54099 SAM BLEHM RD
Second Line	:
City	:	SCAPPOOSE
State	:	OR
Zip	:	97056-2330
Country	:	US
Telephone Number	:	971-344-2937
Fax Number	:

Provider Business Practice Location Address
First Line	:	819 JOHN ADAMS ST
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-1956
Country	:	US
Telephone Number	:	971-344-2937
Fax Number	:

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

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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