Harrison, Russell B

Harrison, Russell B is an individual health care provider with primary practice located at 1600 Se Court Pl Suite 201, Pendleton OR 97801. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Harrison, Russell B can be contacted via phone (541) 276-1700.

Contact Information

Primary practice address
1600 Se Court Pl Suite 201 Pendleton OR 97801
Fax: (541) 276-6327
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X 23092 Nebraska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD29141 Oregon

Profile Details

NPI number 1164409173
LBN Legal business name Harrison, Russell B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jun 29th, 2010 - about 14 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 1164409173 NPPES
Oregon MEDICAID 500606602

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