Individual
MICHAEL FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 750-1135
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
201606429RN
OR
Other
Enumeration date
10/01/2016
Last updated
10/01/2016
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