Individual
HARRY ERNEST VANDERVORT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4000 E 30TH AVE, EUGENE, OR 97405-0640
(541) 463-5665
(541) 463-4164
Mailing address
4000 E 30TH AVE, EUGENE, OR 97405-0640
(541) 463-5665
(541) 463-4164
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
88-000106
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88-000106
NURSE PRACTITIONER LICENS
OR
Enumeration date
04/03/2007
Last updated
03/07/2023
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