Provider Demographics
NPI:1184016412
Name:ROBINSON, REBBECCAH JO (QMHA)
Entity Type:Individual
Prefix:
First Name:REBBECCAH
Middle Name:JO
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E. BURNSIDE ST.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:503-239-8400
Mailing Address - Fax:503-269-8407
Practice Address - Street 1:8041 E. BURNSIDE ST.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215
Practice Address - Country:US
Practice Address - Phone:503-252-3304
Practice Address - Fax:503-254-6396
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator