Provider Demographics
NPI:1326452236
Name:POMERLEAU, ASHLEY (QMHA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:POMERLEAU
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 1:4105 SE INTERNATIONAL WAY
Mailing Address - Street 2:STE 501
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-8855
Mailing Address - Country:US
Mailing Address - Phone:503-496-3201
Mailing Address - Fax:503-496-3208
Practice Address - Street 1:4105 SE INTERNATIONAL WAY
Practice Address - Street 2:STE 501
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-8855
Practice Address - Country:US
Practice Address - Phone:503-496-3201
Practice Address - Fax:503-496-3208
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor