Individual
DR. JERRY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4421 NE ST JOHNS RD, SUITE F, VANCOUVER, WA 98661-2573
(360) 695-9922
(360) 695-1310
Mailing address
4421 NE ST JOHNS RD, SUITE F, VANCOUVER, WA 98661-2573
(360) 695-9922
(360) 695-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10276
WA
208D00000X
General Practice Physician
Primary
10276
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185791
DEPT OF LABOR & INDUSTRIE
WA
05
—
8303000
—
WA
01
—
MD10276
WA STATE CRIME VICTIMS
WA
Enumeration date
06/17/2005
Last updated
12/21/2009
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