Provider Demographics
NPI:1356964647
Name:FRECHETTE, MOLLY ELISSA (MSW, QMHP)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ELISSA
Last Name:FRECHETTE
Suffix:
Gender:F
Credentials:MSW, QMHP
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:ELISSA
Other - Last Name:SESTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8459
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8459
Mailing Address - Country:US
Mailing Address - Phone:503-303-4000
Mailing Address - Fax:503-344-4412
Practice Address - Street 1:17070 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-4960
Practice Address - Country:US
Practice Address - Phone:503-303-4000
Practice Address - Fax:503-344-4412
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health