Provider Demographics
NPI:1144450156
Name:TRISS FIFER PC
Entity type:Organization
Organization Name:TRISS FIFER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRISS
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-222-2420
Mailing Address - Street 1:833 SW 11TH AVE
Mailing Address - Street 2:SUITE 913
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2123
Mailing Address - Country:US
Mailing Address - Phone:503-222-2420
Mailing Address - Fax:503-222-5395
Practice Address - Street 1:833 SW 11TH AVE
Practice Address - Street 2:SUITE 913
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2123
Practice Address - Country:US
Practice Address - Phone:503-222-2420
Practice Address - Fax:503-222-5395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty