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General NPI Number Information
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NPI Number | 1801076542
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Entity Type | Organization
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Legal Business Name | JD HARRIS PC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 11020 SW BEAVERTON HILLSDALE HWY
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City | BEAVERTON
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State | OR
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Zip | 97005-3007
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Country | US
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Telephone | 503-789-6720
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Fax | 503-644-8330
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Provider Business Mailing Address
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Address Line | 11020 SW BEAVERTON HILLSDALE HWY
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City | BEAVERTON
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State | OR
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Zip | 97005-3007
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Country | US
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Telephone | 503-526-9697
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Fax | 503-644-8330
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Authorized Official
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Title or Position | CORPORATE SECRETARY/BUSINESS MANAGE
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Name | IRENE ERNESTINA OLIVIERI-HARRIS
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Credential |
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Telephone | 503-526-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1863T
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License Number State | OR
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