MEDICARE: NATHAN ANDREW FINGERSON QMHP

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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992335582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN ANDREW FINGERSON QMHP

Provider Business Mailing Address
First Line	:	1616 NW 36TH ST
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-4814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 NW 36TH ST
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-4814
Country	:	US
Telephone Number	:	503-991-4173
Fax Number	:

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

Provider Enumeration Date	:	01/22/2020
Last Update Date	:	04/11/2022

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