Ca Djurkovic, QMHA-R, PSS,

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000104697 Issued in OR

Practice address

2411 MLK Blvd
Eugene, OR 97401-5824

Phone

(541) 342-8255

NPI assigned

Mar 30, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1912647892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 E 12TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 MLK BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015824",
            "telephone_number": "541-342-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJURKOVIC",
        "first_name": "CA",
        "credential": "QMHA-R, PSS,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000104697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piper Marie-Fondeveille Dishman, MS, NCC
• Indra Dissanayake
• Michelle Lynn Ditter, LMT
• Dewayne Edwin Ditto, MD
• John Dixon
• DLX Enterprises LLC
• Lisa DO, PHARM.D.
• Isabella Uyen Doan
• Tracey Lee Dobbins, LMT
• Teresa Dobles, PSY.D.

• Peer Specialist in Eugene, OR
• Providers in Eugene, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.