Healthcare Provider Details

I. General information

NPI: 1538189782
Provider Name (Legal Business Name): LINDA HARRIES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SE COURT PL SUITE 201
PENDLETON OR
97801-3281
US

IV. Provider business mailing address

1100 SOUTHGATE, STE 6 PO BOX 1125
PENDLETON OR
97801
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1700
  • Fax: 541-276-6327
Mailing address:
  • Phone: 541-215-1564
  • Fax: 541-215-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: