Individual
STACIE NICOLE FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
147 COMMERCIAL ST NE, SALEM, OR 97301-3416
(503) 589-3122
Mailing address
PO BOX 3417, PORTLAND, OR 97208-3417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C9713
OR
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
04/02/2021
Last updated
05/06/2025
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