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Individual

KAREN GAYE HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
200 S HAZEL DELL WAY, CANBY, OR 97013-7829
(503) 263-9500
(503) 263-1383
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18948
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069232
OR
01
P00910531
RR MEDICARE
OR
Enumeration date
12/07/2006
Last updated
12/14/2012
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