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Individual

MERRIAH SIERRA FAIRCHILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PPD, IBCLC

Contact information

Practice address
1703 SW CLAY ST, PORTLAND, OR 97201-2528
(503) 970-9554
Mailing address
5439 SE RAYMOND ST, PORTLAND, OR 97206-4853

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
374J00000X
Doula
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81-5065544
CPT 59430, 99501, 99502, 59430
OR
Enumeration date
06/26/2020
Last updated
06/26/2020
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