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Individual

MR. KEVIN L FISHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3550 SE WOODWARD ST, PORTLAND, OR 97202-1552
(503) 517-8663
Mailing address
5519 SW MULTNOMAH BLVD, PORTLAND, OR 97219-3269
(503) 896-8696

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
10/09/2008
Last updated
10/09/2008
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