Fisher, Jerry

Fisher, Jerry is an individual health care provider with primary practice located at 4421 Ne St Johns Rd Suite F, Vancouver WA 98661-2573. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Fisher, Jerry can be contacted via phone (360) 695-9922.

Contact Information

Primary practice address
4421 Ne St Johns Rd Suite F Vancouver WA 98661-2573
Phone: (360) 695-9922
Fax: (360) 695-1310
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 10276 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10276 Washington

Profile Details

NPI number 1568467223
LBN Legal business name Fisher, Jerry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Dec 21st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568467223 NPPES
Washington Other 0185791 DEPT OF LABOR & INDUSTRIE
Washington MEDICAID 8303000 DEPT OF LABOR & INDUSTRIE
Washington Other MD10276 DEPT OF LABOR & INDUSTRIE

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