Provider Demographics
NPI:1366464570
Name:FOSTER, JEFFERY FRANKLIN (QMHP)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:FRANKLIN
Last Name:FOSTER
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 1:1712 SE 111TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-6200
Mailing Address - Country:US
Mailing Address - Phone:360-326-3816
Mailing Address - Fax:
Practice Address - Street 1:131 NE 102ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4167
Practice Address - Country:US
Practice Address - Phone:503-253-6754
Practice Address - Fax:503-251-1344
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health