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NPI Code Detail

MEDICARE: VIRGINIA LEE HARRIS NP

MEDICARE: VIRGINIA LEE HARRIS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner200550028NPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1067593032OTHERORBLUE CROSS/SHIELD PIN

General Provider Information

NPI Number : 1043247059
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA LEE HARRIS NP
Provider Business Mailing Address
First Line : 5100 SW MACADAM AVE
Second Line : SUITE 200
City : PORTLAND
State : OR
Zip : 97239-6102
Country : US
Telephone Number : 971-202-5500
Fax Number : 971-202-5555
Provider Business Practice Location Address
First Line : 5100 SW MACADAM AVE
Second Line : SUITE 200
City : PORTLAND
State : OR
Zip : 97239-6102
Country : US
Telephone Number : 971-202-5500
Fax Number : 971-202-5555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 01/22/2013

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Directions to “ VIRGINIA LEE HARRIS NP” Practice Location

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