Active NPI
Linda M. Fishman, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1487717609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1397
- Practice address
- 2153 SW Main St
Suite 102
Portland, OR 97205-1124 - Phone
- (503) 705-9462
- Fax
- (503) 227-4212
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1397 | OR | Primary |
Addresses
Primary practice location
2153 SW Main St
Suite 102
Portland, OR 97205-1124
Mailing address
2153 SW Main St
Suite 102
Portland, OR 97205-1124
Phone (503) 705-9462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 840665000 | Other | OR | REGENCE BCBSO |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1397 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1487717609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2153 SW MAIN ST",
"address_2": "SUITE 102",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051124",
"telephone_number": "503-705-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2153 SW MAIN ST",
"address_2": "SUITE 102",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051124",
"telephone_number": "503-705-9462",
"fax_number": "503-227-4212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHMAN",
"first_name": "LINDA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BCBSO",
"identifier": "840665000",
"state": "OR"
}
],
"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 Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.