Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Trista Faye Breitenbauch, SUDP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1124576418

Mrs. Trista Faye Breitenbauch, SUDP is an Addiction (Substance Use Disorder) Counselor in Vancouver, Washington. Licensed in Washington. Registered with an NPI since 2016.

Licensed in
WA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1601 E Fourth Plain Blvd Bldg 17
Vancouver, WA 98661-3717
Phone: (360) 605-7628
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CO 60255487 (WA)

Record details

NPI number1124576418
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDP
Sole proprietorNo
NPI enumeratedSeptember 14, 2016
Last updated in NPPESApril 20, 2021
Certification dateApril 20, 2021

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