MRS. AMY JEAN DOUGLAS NPI 1104785401

NPI Information

  • NPI: 1104785401
  • Provider Name: MRS. AMY JEAN DOUGLAS
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Individual
  • Address: 1175 E MAIN ST
    MEDFORD, OR
    ZIP 97504
  • Phone: (458) 488-1250

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NPI Details

MRS. Amy Jean Douglas is a mental health (including community mental health center) clinic center in Medford, OR. MRS. Amy Jean Douglas NPI is 1104785401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1175 E MAIN ST
MEDFORD, OR
ZIP 97504-499
Phone: (458) 488-1250
Fax: (458) 488-1252

The enumeration date for this NPI number is 1/21/2026 and was last updated on 1/21/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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