Provider Demographics
NPI:1063409837
Name:HARR, DONALD L (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:HARR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 PORTLAND RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1371
Mailing Address - Country:US
Mailing Address - Phone:503-538-3277
Mailing Address - Fax:503-537-0615
Practice Address - Street 1:2207 PORTLAND RD
Practice Address - Street 2:SUITE A
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1371
Practice Address - Country:US
Practice Address - Phone:503-538-3277
Practice Address - Fax:503-537-0615
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1017T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080515Medicaid
OR080515Medicaid
ORT83490Medicare UPIN