Individual
STEPHANIE MICHELLE FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
5023 NE KILLINGSWORTH ST, PORTLAND, OR 97218-1915
(503) 544-4499
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 544-4499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/04/2011
Last updated
04/07/2014
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