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General NPI Number Information
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NPI Number | 1346167020
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Entity Type | Individual
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Provider Name | BRYCE FARGHER QMHA-R, CADC-R
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Gender | Male
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 3636 NE BROADWAY, PORTLAND, OR 97232
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City | PORTLAND
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State | OR
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Zip | 97232
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Country | US
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Telephone | 503-548-0346
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Fax | 503-232-5959
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 971-217-9008
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Fax | 971-260-0355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | T-26-6593
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 26-QMHA-R-8744
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License Number State | OR
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