Healthcare Provider Details

I. General information

NPI: 1033161997
Provider Name (Legal Business Name): JOHN CARL MORRISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 SW BOND AVE
PORTLAND OR
97239-4501
US

IV. Provider business mailing address

3303 SW BOND AVE
PORTLAND OR
97239-4501
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-3000
  • Fax: 503-418-0843
Mailing address:
  • Phone: 503-494-3000
  • Fax: 503-418-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD11369
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberMD11369
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: