Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeanette Marie Fanning, QMHA

Individual provider Mental Illness Community Based Residential Treatment Facility · NPI 1912045139

Jeanette Marie Fanning, QMHA is a Mental Illness Community Based Residential Treatment Facility in Portland, Oregon. Practices as a sole proprietor. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2

Practice location Address checks out

2375 NW Glisan St
Portland, OR 97210-3420
Phone: (503) 243-2236
Fax: (503) 243-2429
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X

Record details

NPI number1912045139
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHA
Sole proprietorYes
NPI enumeratedFebruary 1, 2007
Last updated in NPPESSeptember 11, 2025

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