Healthcare Provider Details

I. General information

NPI: 1710444013
Provider Name (Legal Business Name): KRISTEN PFEIFFER QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2019
Last Update Date: 02/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E 11TH AVE
EUGENE OR
97401-3746
US

IV. Provider business mailing address

1115 NE 164TH AVE. DEPT. 358
VANCOUVER WA
98683
US

V. Phone/Fax

Practice location:
  • Phone: 458-205-7474
  • Fax:
Mailing address:
  • Phone: 360-729-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: