Provider Demographics
NPI:1336123462
Name:FISCHER, BRITTA C (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTA
Middle Name:C
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1338
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-7785
Mailing Address - Country:US
Mailing Address - Phone:360-423-9580
Mailing Address - Fax:360-423-6230
Practice Address - Street 1:783 COMMERCE AVE STE 300
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2495
Practice Address - Country:US
Practice Address - Phone:360-423-9528
Practice Address - Fax:360-423-6230
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003147363A00000X
NC0010-06060363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00254561OtherRAILROAD MEDICARE
AZ86080015085259C019OtherTRIWEST
AZ948812Medicaid
AZ948812Medicaid
AZ86080015085259C019OtherTRIWEST