Provider Demographics
NPI:1871689273
Name:FISHER, NANCY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LOUISE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-1719
Mailing Address - Country:US
Mailing Address - Phone:206-275-1927
Mailing Address - Fax:206-275-1928
Practice Address - Street 1:676 WOODLAND SQ LOOP SE
Practice Address - Street 2:MS 42701
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98504-2701
Practice Address - Country:US
Practice Address - Phone:360-923-2709
Practice Address - Fax:360-923-2766
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA252 09 0016821207SG0201X
WA252 9 0016821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1054576Medicaid
WA109673Medicare ID - Type UnspecifiedPROVIDER NUMBER