Individual
MS. JODIE LYNN PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
51 SW LEE ST, NEWPORT, OR 97365-3823
(541) 574-5960
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0445
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
THW1458
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500776143
—
OR
Enumeration date
05/01/2018
Last updated
06/03/2020
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