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Individual

JACQUELYNN CAROL HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
901 BRUTSCHER ST, D163, NEWBERG, OR 97132-6096
(503) 625-9190
Mailing address
901 BRUTSCHER ST, D163, NEWBERG, OR 97132-6096
(503) 625-9190

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO29050
OR
207Q00000X
Family Medicine Physician
K3747
TX

Other

Enumeration date
10/06/2006
Last updated
12/11/2015
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