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General NPI Number Information
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NPI Number | 1265612477
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Entity Type | Individual
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Provider Name | PATRICIA LYNN HARRIS PSY,D.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 12636 SE STARK ST., PLAZA 125, BUILDING J
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City | PORTLAND
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State | OR
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Zip | 97233
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Country | US
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Telephone | 503-253-4600
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Fax | 503-233-4609
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Provider Business Mailing Address
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Address Line | 12607 SE MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98684-6055
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Country | US
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Telephone | 855-632-8280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1731
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License Number State | OR
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