Provider Demographics
NPI:1134458052
Name:PROJECT QUEST
Entity Type:Organization
Organization Name:PROJECT QUEST
Other - Org Name:QUEST CENTER FOR INTEGRATIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS & COMPLAINCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:LYNDEL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:503-238-5203
Mailing Address - Street 1:2901 E BURNSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1831
Mailing Address - Country:US
Mailing Address - Phone:503-238-5203
Mailing Address - Fax:503-238-5202
Practice Address - Street 1:2901 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1831
Practice Address - Country:US
Practice Address - Phone:503-238-5203
Practice Address - Fax:503-238-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287030Medicaid
ORR116581Medicare PIN