Individual
DANIEL LEWIS FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
165205
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165205
LICENSE NUMBER
OR
Enumeration date
01/18/2017
Last updated
01/18/2017
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