Most Relevant Information
Provider Data
| NPI Number: | 1003369893 |
| Provider Name: | JENNIFER WILLIS QMHA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/27/2016 |
| Last Updated: | 07/14/2023 |
Provider Practice Location
18417 SE OAK ST
PORTLAND
OR
972334850
Practice Location Phone/Fax
| Phone: | 9717278026 |
| Fax: |
Provider Mailing Location
14600 NW CORNELL RD
PORTLAND
OR
972295442
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |