Provider Demographics
NPI:1235279480
Name:BARRON, LORI ANN (QMHA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:BARRON
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 1:1521 SE 21ST AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4892
Mailing Address - Country:US
Mailing Address - Phone:503-829-3949
Mailing Address - Fax:503-827-0931
Practice Address - Street 1:310 NW FLANDERS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3941
Practice Address - Country:US
Practice Address - Phone:503-827-3949
Practice Address - Fax:503-827-0931
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator