Provider Demographics
NPI:1144507195
Name:FISHER, MARY ELIZABETH (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:FISHER
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LMFT
Mailing Address - Street 1:17075 SW ARKENSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7601
Mailing Address - Country:US
Mailing Address - Phone:503-381-7433
Mailing Address - Fax:503-470-7245
Practice Address - Street 1:17075 SW ARKENSTONE DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97224-7601
Practice Address - Country:US
Practice Address - Phone:503-381-7433
Practice Address - Fax:503-470-7245
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORORT0773(SAME)101Y00000X, 101YP1600X
ORORT0773101Y00000X, 106H00000X
CA48569106H00000X
ORT0773106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral