Individual
MR. TOD EVAN FISTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, MFT
Contact information
Practice address
1815 NW FLANDERS ST, SUITE 101, PORTLAND, OR 97209-2060
(503) 946-6499
(503) 966-7948
Mailing address
1815 NW FLANDERS ST, SUITE 101, PORTLAND, OR 97209-2060
(503) 946-6499
(503) 966-7948
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2614
OR
106H00000X
Marriage & Family Therapist
MFC44519
CA
Other
Enumeration date
06/02/2011
Last updated
07/30/2015
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