Individual ProviderAlisa Gail FowlerCounselorBehavioral Health & Social Service ProvidersPractice Address1021 W 9th St, The Dalles, OR 97058-1007(541) 298-1920(541) 858-8170PECOS EnrollmentBased on the most recent information from CMS, provider Alisa Gail Fowler does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1881944049Provider TypeIndividualFull NameFowler, Alisa GailGenderFemaleSole ProprietorYesEnumeration Date9/14/2012Last Updated7/21/2022Contact InformationPractice LocationPractice Address1021 W 9th St, The Dalles, OR 97058-1007Phone(541) 298-1920Fax(541) 298-1917Mailing LocationMailing Address3587 Heathrow Way, Medford, OR 97504-4004Phone(541) 858-8170Fax(541) 858-8167Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer