Individual provider · Type 1 NPI

Gina Dora Patriarca, QMHP

Mental Health Counselor · Portland, OR

NPI number 1427066604 Active

Practice location

847 NE 19th Ave Ste 100
Portland, OR 97232

Mailing address

PO Box 8459
Portland, OR 97207-8459

Other practice locations

  • 412 SW 12th Ave, Portland, OR 97205-2329 · (503) 552-0767

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1427066604

Gina Dora Patriarca, QMHP's National Provider Identifier is 1427066604, issued on Aug 4, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Jun 11, 2019.