Provider Demographics
NPI:1396300497
Name:MYERS, PATRICIA JOANNE (MS, QMHP, NCC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JOANNE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS, QMHP, NCC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JOANNE
Other - Last Name:MCKIRCHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2905 RIVER RD S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9754
Mailing Address - Country:US
Mailing Address - Phone:503-391-7175
Mailing Address - Fax:503-585-3303
Practice Address - Street 1:2905 RIVER RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:503-391-7175
Practice Address - Fax:503-585-3303
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor