Individual
JESSICA L FISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1500 NE IRVING ST STE 250, PORTLAND, OR 97232-2265
(503) 258-4400
Mailing address
9 NE 31ST AVE APT 202, PORTLAND, OR 97232-3280
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A1769
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1769
CLINICAL SW ASSOC LIC #
OR
Enumeration date
04/23/2007
Last updated
07/08/2007
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