Healthcare Provider Details

I. General information

NPI: 1578223681
Provider Name (Legal Business Name): KRISTINA V FISHER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NE 139TH ST STE 120
VANCOUVER WA
98686-2301
US

IV. Provider business mailing address

409 NW 150TH WAY
VANCOUVER WA
98685-1745
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-1717
  • Fax:
Mailing address:
  • Phone: 503-602-2605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP61283820
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: