Provider Demographics
NPI:1740632090
Name:FANSHIER, ERIN (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FANSHIER
Suffix:
Gender:F
Credentials:MSW
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 33530
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292-3530
Mailing Address - Country:US
Mailing Address - Phone:971-266-0519
Mailing Address - Fax:
Practice Address - Street 1:7211 SE 62ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-7564
Practice Address - Country:US
Practice Address - Phone:971-266-0519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker