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General NPI Number Information
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NPI Number | 1801986724
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Entity Type | Individual
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Provider Name | ADRIENNE LEIGH FISCHL D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 2520 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97214-1754
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Country | US
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Telephone | 503-233-3622
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Fax | 503-233-5882
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Provider Business Mailing Address
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Address Line | 1624 SE 52ND AVE
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City | PORTLAND
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State | OR
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Zip | 97215-3318
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Country | US
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Telephone | 503-233-3622
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Fax | 503-233-5882
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D8292
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License Number State | OR
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