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

Mary Rose Waggoner, QMHA

Individual provider Case Manager/Care Coordinator · NPI 1083979264

Mary Rose Waggoner, QMHA is a Case Manager/Care Coordinator in Roseburg, Oregon. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
3

Practice location Address checks out

621 W Madrone St
Roseburg, OR 97470-3090
Phone: (541) 440-3532
Fax: (541) 440-3554
Show map & directions

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

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X
Case Manager/Care Coordinator Taxonomy 171M00000X
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1083979264
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHA
Sole proprietorNo
NPI enumeratedJuly 12, 2012
Last updated in NPPESFebruary 14, 2022
Certification dateFebruary 14, 2022

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