Harrison, Charles Way

Harrison, Charles Way is an sole proprietor health care provider with primary practice located at 1210 Se Oak St , Portland OR 97214-1427. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Harrison, Charles Way can be contacted via phone (503) 975-0014.

Contact Information

Primary practice address
1210 Se Oak St Portland OR 97214-1427
Fax: (503) 283-7085
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1148 Oregon

Profile Details

NPI number 1437131646
LBN Legal business name Harrison, Charles Way
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2005
Last updated Jul 23rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437131646 NPPES
Oregon MEDICAID 500612148

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