Provider Demographics
NPI:1134454507
Name:IRBY, LEANNA J (QMHA)
Entity type:Individual
Prefix:MRS
First Name:LEANNA
Middle Name:J
Last Name:IRBY
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 1:1785 BERRY ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3004
Mailing Address - Country:US
Mailing Address - Phone:503-576-4570
Mailing Address - Fax:503-361-2782
Practice Address - Street 1:1785 BERRY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-3004
Practice Address - Country:US
Practice Address - Phone:503-576-4570
Practice Address - Fax:503-361-2782
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator