Most Relevant Information
Provider Data
| NPI Number: | 1003663188 |
| Provider Name: | JAMES PERRY GOURLIE QMHA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/06/2024 |
| Last Updated: | 05/31/2024 |
Provider Practice Location
331 SE 2ND ST
PENDLETON
OR
978012224
Practice Location Phone/Fax
| Phone: | 5412766207 |
| Fax: | 5412764628 |
Provider Mailing Location
PO BOX 469
HEPPNER
OR
978360469
Provider Mailing Phone/Fax
| Phone: | 5416769161 |
| Fax: | 5416765662 |