Fanning, Jeanette Marie

Fanning, Jeanette Marie is an sole proprietor health care provider with primary practice located at 2375 Nw Glisan St , Portland OR 97210-3420. She recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Other Service Providers / Case Manager/Care Coordinator. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is her primary health care specialty. Fanning, Jeanette Marie can be contacted via phone (503) 243-2236.

Contact Information

Primary practice address
2375 Nw Glisan St Portland OR 97210-3420
Phone: (503) 243-2236
Fax: (503) 243-2429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1912045139
LBN Legal business name Fanning, Jeanette Marie
Credentials QMHA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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