MEDICARE: CLAUDIE JEAN FISHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		OR

General Provider Information

NPI Number	:	1043154032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIE JEAN FISHER

Provider Business Mailing Address
First Line	:	4424 SE 15TH AVE APT 4424
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-4703
Country	:	US
Telephone Number	:	503-997-8072
Fax Number	:

Provider Business Practice Location Address
First Line	:	7175 SW BEVELAND RD STE 200
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97223-8665
Country	:	US
Telephone Number	:	971-213-5025
Fax Number	:	971-228-5431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2026
Last Update Date	:	04/18/2026

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Directions to “ CLAUDIE JEAN FISHER ” Practice Location

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