LAURA ANNE PETTIS-CLARK QMHA-R
NPI 1174133953
Case Manager/Care Coordinator in Clackamas, OR

Q: What is Laura Pettis-clark's NPI number?

The NPI number for Laura Pettis-clark is 1174133953. It was assigned to this individual provider in the NPPES registry on August 5, 2020.

Q: What is Laura Pettis-clark's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Active since August 05, 2020

12901 SE 97TH AVE STE 340, CLACKAMAS, OR 97015(503) 655-8045(523) 655-6806 Get Directions Write a Review

NPPES record last updated: August 5, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Laura Anne Pettis-clark Qmha-r NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAURA ANNE PETTIS-CLARK QMHA-R (NPI 1174133953) is an individual case manager/care coordinator provider in Clackamas, Oregon and active in the NPI registry since August 2020.

NPPES Registry Identity

NPI1174133953

Entity TypeIndividualFemale

Primary Taxonomy171M00000X

Provider Legal NameLAURA ANNE PETTIS-CLARKCredential: QMHA-R

Location Address12901 SE 97TH AVE STE 340Clackamas, OR 97015-7903

Mailing Address2300 Ne 165th DrPortland, OR 97230-5525 · (971) 285-2476

Phone(503) 655-8045

Fax(523) 655-6806

Sole ProprietorNo

Enumeration DateAugust 5, 2020

NPPES CertifiedAugust 5, 2020

✔ NPI 1174133953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

12901 SE 97TH AVE STE 340, Clackamas, OR 97015

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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