Individual
JEREMY BELLEQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA-R
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 672-2691
(833) 299-8415
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
(833) 299-8415
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/15/2021
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