Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ORT0773 | OR |
N | 101Y00000X | Counselor | ORT0773(SAME) | OR |
N | 101YP1600X | Pastoral Counselor | ORT0773(SAME) | OR |
NPI | 1144507195 |
---|---|
Provider Name | Dr. Mary Elizabeth Fisher |
First Address | Portland, OR 97223-5727 |
Second Address | Portland, OR 97223-2513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2011 |
Last Update Date | 03/07/2015 |