Individual
ADAM JOHN FISHBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 813-2000
Mailing address
500 NE MULTNOMAH ST FL 11, PORTLAND, OR 97232-2023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201390444RN
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
202111766CRNA-PP
OR
Other
Enumeration date
04/20/2021
Last updated
08/13/2025
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