Provider Demographics
NPI:1184023681
Name:JANOSKI, JAMES R (QMHP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:JANOSKI
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3995 MARCOLA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-7948
Mailing Address - Country:US
Mailing Address - Phone:541-726-1465
Mailing Address - Fax:541-726-5085
Practice Address - Street 1:369 NE REVERE AVE STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701
Practice Address - Country:US
Practice Address - Phone:541-728-0062
Practice Address - Fax:541-306-6733
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health