Provider Demographics
NPI:1609376557
Name:FLETCHER, SCOTT (LMFT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 NE 92ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5221
Mailing Address - Country:US
Mailing Address - Phone:503-388-9475
Mailing Address - Fax:971-350-2362
Practice Address - Street 1:2705 E BURNSIDE ST STE 206
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1768
Practice Address - Country:US
Practice Address - Phone:503-388-9475
Practice Address - Fax:971-350-2362
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist