MEDICARE: MS. PATRICIA GARNER CADC QMHP MED

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	950441
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1982707915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA GARNER CADC QMHP MED

Provider Business Mailing Address
First Line	:	2405 SE 40TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-5923
Country	:	US
Telephone Number	:	503-236-7347
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 NE 102ND AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-4167
Country	:	US
Telephone Number	:	503-253-6754
Fax Number	:	503-251-1344

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	09/11/2025

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