Active NPI
Pamela Ann Fisher, M.D.
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1093909830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD15128
- Practice address
- 707 SW Gaines St # CDRC-P
Dept of Pediatrics Ohsu
Portland, OR 97239-2901 - Phone
- (503) 636-4190
- NPI assigned
- Sep 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD15128 | OR | Primary |
Addresses
Primary practice location
707 SW Gaines St # CDRC-P
Dept of Pediatrics Ohsu
Portland, OR 97239-2901
Mailing address
707 SW Gaines St # CDRC-P
Dept of Pediatrics Ohsu
Portland, OR 97239-2901
Phone (503) 636-4190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15128 | OR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188950400000",
"number": "1093909830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SW GAINES ST # CDRC-P",
"address_2": "DEPT OF PEDIATRICS OHSU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "503-636-4190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES ST # CDRC-P",
"address_2": "DEPT OF PEDIATRICS OHSU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "503-636-4190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "PAMELA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-05",
"last_updated": "2007-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD15128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.