Provider Demographics
NPI:1689908485
Name:FISCHER, BREANNA FAITH (MSMFT)
Entity Type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:FAITH
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MSMFT
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:FAITH
Other - Last Name:AGNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSMFT
Mailing Address - Street 1:1845 SE 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2935
Mailing Address - Country:US
Mailing Address - Phone:360-798-0004
Mailing Address - Fax:
Practice Address - Street 1:9300 NE OAK VIEW DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6347
Practice Address - Country:US
Practice Address - Phone:360-567-2211
Practice Address - Fax:360-567-2212
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist