Individual
DR. RUSSELL B HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SE COURT PL, SUITE 201, PENDLETON, OR 97801
(541) 276-1700
(541) 276-6327
Mailing address
PO BOX 190, PENDLETON, OR 97801
(541) 276-1700
(541) 276-6327
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
23092
NE
207Q00000X
Family Medicine Physician
Primary
MD29141
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500606602
—
OR
Enumeration date
12/30/2005
Last updated
06/29/2010
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