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General NPI Number Information
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NPI Number | 1639935349
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Entity Type | Individual
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Provider Name | EMILEE HARRIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 6700 SW 105TH AVE
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City | BEAVERTON
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State | OR
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Zip | 97008-8830
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Country | US
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Telephone | 503-461-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 CHARDIN WAY
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City | MARIETTA
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State | GA
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Zip | 30062-2140
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Country | US
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Telephone | 503-926-3578
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L10882
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License Number State | OR
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