Individual
KELLY FISCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1475 SE 100TH AVE, PORTLAND, OR 97216-2537
(408) 768-6405
Mailing address
1475 SE 100TH AVE, PORTLAND, OR 97216-2537
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
222331
OR
Other
Enumeration date
04/29/2017
Last updated
04/29/2017
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