Provider Demographics
NPI:1386612760
Name:FISHER, CAROLINE E (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:E
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3857
Mailing Address - Country:US
Mailing Address - Phone:503-269-3610
Mailing Address - Fax:
Practice Address - Street 1:2727 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3857
Practice Address - Country:US
Practice Address - Phone:503-269-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1577452084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD157745OtherOMB LICENSE NUMBER
WAMD60887411OtherSTATE MEDICAL LICENSE
MA213699OtherSTATE MEDICAL LICENSE