Healthcare Provider Details

I. General information

NPI: 1770400673
Provider Name (Legal Business Name): KAREN JOY HARRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 4TH ST STE 1
LA GRANDE OR
97850-2558
US

IV. Provider business mailing address

1902 4TH ST STE 1
LA GRANDE OR
97850-2558
US

V. Phone/Fax

Practice location:
  • Phone: 541-809-1669
  • Fax:
Mailing address:
  • Phone: 541-809-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: