Harrison, Marvin William

Harrison, Marvin William is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Harrison, Marvin William can be contacted via phone (503) 494-7764.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-7764
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X MD09947 Oregon

Profile Details

NPI number 1558379016
LBN Legal business name Harrison, Marvin William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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 1558379016 NPPES
Oregon MEDICAID 042135

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