Jeanette Marie Fanning, QMHA is a community based residential treatment facility mental illness in Portland, OR. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. Jeanette Marie Fanning, QMHA NPI is 1912045139. 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:
2375 NW GLISAN ST
PORTLAND, OR
ZIP 97210-420
Phone: (503) 243-2236
Fax: (503) 243-2429
The enumeration date for this NPI number is 2/1/2007 and was last updated on 7/8/2007.