Individual
TIMOTHY L FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1904 SE DIVISION ST, PORTLAND, OR 97202-1146
(503) 517-8663
Mailing address
935 SE 14TH AVE, PORTLAND, OR 97214-2549
(206) 328-5696
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
01/27/2026
Last updated
01/27/2026
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