Provider Demographics
NPI:1962469551
Name:HARRIS, H FREEMAN (MD)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:FREEMAN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HENRY
Other - Middle Name:F
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4309 OAKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3418
Mailing Address - Country:US
Mailing Address - Phone:503-636-9687
Mailing Address - Fax:503-636-9680
Practice Address - Street 1:4309 OAKRIDGE RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3418
Practice Address - Country:US
Practice Address - Phone:503-636-9687
Practice Address - Fax:503-636-9680
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD9151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR112141Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ORC92816Medicare UPIN