Provider Demographics
NPI:1346526712
Name:GARCIA-MENDEZ, JOSE (QMHA)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:GARCIA-MENDEZ
Suffix:
Gender:M
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 N PACIFIC HWY
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-3731
Mailing Address - Country:US
Mailing Address - Phone:503-981-5851
Mailing Address - Fax:503-566-2977
Practice Address - Street 1:976 N PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-3731
Practice Address - Country:US
Practice Address - Phone:503-981-5851
Practice Address - Fax:503-566-2977
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator