Individual
MARTIN BRIAN FISHER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1215 SW 18TH AVE, SUITE 4, PORTLAND, OR 97205-1711
(503) 318-3236
Mailing address
2420 SE TAYLOR ST, PORTLAND, OR 97214-2858
(503) 318-3236
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
2383
OR
103TC0700X
Clinical Psychologist
Primary
2383
OR
103TC2200X
Clinical Child & Adolescent Psychologist
2383
OR
103TF0000X
Family Psychologist
2383
OR
Other
Enumeration date
08/06/2013
Last updated
07/03/2014
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