| Doctor Name: | DR. BART JAMES FOWLER |
| NPI Number: | 1003194564 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 1297 |
| Business Practice Address: | 11802 Ne 117th Ave Vancouver, WA - 986621560 |
| Business Phone Number: | 3608912000 |
| Business Fax Number: | 3609446965 |
| Mailing Address: | 11802 Ne 117th Ave, VANCOUVER |
| State: | WA |
| Postal Code: | 986621560 |
| Phone Number: | 3608912000 |
| Fax Number: | 3609446965 |
| NPI Enumeration Date: | 08/01/2011 |
| NPI Last Update Date: | 08/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 1297 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |