Provider Demographics
NPI:1336165331
Name:FLEMING, ANNE MAUREEN (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MAUREEN
Last Name:FLEMING
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 1:2340 NW THURMAN ST
Mailing Address - Street 2:STE 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2579
Mailing Address - Country:US
Mailing Address - Phone:503-701-0996
Mailing Address - Fax:971-413-7200
Practice Address - Street 1:2340 NW THURMAN ST
Practice Address - Street 2:STE 202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2579
Practice Address - Country:US
Practice Address - Phone:503-701-0996
Practice Address - Fax:971-413-7200
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1634902084P0800X
CAA666112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD163490OtherOREGON LICENSE
ORMD163490OtherOREGON LICENSE
CA00A666111Medicare ID - Type Unspecified